Provider Demographics
NPI:1245217009
Name:FERRARY, SUSAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:FERRARY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4 ATRIUM DR
Mailing Address - Street 2:SUITE 100; ATTN: TAMMY M. BUTTON
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1441
Mailing Address - Country:US
Mailing Address - Phone:518-435-2740
Mailing Address - Fax:518-458-2610
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:6 CUSACK - PRIME CARE HOSPITALIST PROGRAM
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1707
Practice Address - Country:US
Practice Address - Phone:518-525-8600
Practice Address - Fax:518-525-6891
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY139739207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00686719Medicaid
NYD76897Medicare UPIN
NY00686719Medicaid