Provider Demographics
NPI:1497307276
Name:SUZAMIE J FARNSWORTH DO, P.C.
Entity Type:Organization
Organization Name:SUZAMIE J FARNSWORTH DO, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZAMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:315-462-0611
Mailing Address - Street 1:460 E LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 COULTER RD
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-1122
Practice Address - Country:US
Practice Address - Phone:315-462-0611
Practice Address - Fax:315-462-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty