Provider Demographics
NPI:1407167315
Name:SUSSMAN, ESTHER
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:
Last Name:SUSSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 OCEAN PKWY
Mailing Address - Street 2:APT 2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5154
Mailing Address - Country:US
Mailing Address - Phone:718-338-4881
Mailing Address - Fax:
Practice Address - Street 1:1225 OCEAN PKWY
Practice Address - Street 2:APT 2F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5154
Practice Address - Country:US
Practice Address - Phone:718-338-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017709235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist