Provider Demographics
NPI:1386663235
Name:SUOZZI, WILLIAM GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GREGORY
Last Name:SUOZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:234 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6003
Mailing Address - Country:US
Mailing Address - Phone:212-579-2200
Mailing Address - Fax:212-579-2212
Practice Address - Street 1:234 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6003
Practice Address - Country:US
Practice Address - Phone:212-579-2200
Practice Address - Fax:212-579-2212
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164950207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW35591OtherGROUP MEDICARE PIN
NY20E6835591Medicare PIN
NYA61193Medicare UPIN