Provider Demographics
NPI:1417202979
Name:SANSEVERINO, SUZANNE
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:SANSEVERINO
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 1:2035 CENTRAL PARK AVE
Mailing Address - Street 2:APT LC
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2445
Mailing Address - Country:US
Mailing Address - Phone:914-469-1998
Mailing Address - Fax:
Practice Address - Street 1:2035 CENTRAL PARK AVE
Practice Address - Street 2:APT LC
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2445
Practice Address - Country:US
Practice Address - Phone:914-469-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist