Provider Demographics
NPI:1265502546
Name:LITTLER, SUSAN JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:JEAN
Last Name:LITTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:175 WALNUT AVE, GENERAL PHYSICIAN PC
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094
Mailing Address - Country:US
Mailing Address - Phone:716-675-5222
Mailing Address - Fax:716-439-1233
Practice Address - Street 1:726 EXCHANGE STREET, GENERAL PHYSICIAN PC
Practice Address - Street 2:SUITE 710
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210
Practice Address - Country:US
Practice Address - Phone:716-463-6960
Practice Address - Fax:716-314-0421
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY190730207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI505307 01Medicaid
HI0000233791OtherHMSA
HIG33642Medicare UPIN
HI54615Medicare ID - Type Unspecified