Provider Demographics
NPI:1285654376
Name:SUGG, SAMUEL CLARKSON (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:CLARKSON
Last Name:SUGG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1090 AMSTERDAM AVE
Mailing Address - Street 2:SUITE 16C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1737
Mailing Address - Country:US
Mailing Address - Phone:212-523-2965
Mailing Address - Fax:212-636-1303
Practice Address - Street 1:1090 AMSTERDAM AVE
Practice Address - Street 2:SUITE 16C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-523-2965
Practice Address - Fax:212-636-1303
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-06-07
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Provider Licenses
StateLicense IDTaxonomies
NY1206992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY348611Medicare ID - Type UnspecifiedMEDICARE