Provider Demographics
NPI:1508853805
Name:CLARVIT, SUSAN RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:RUTH
Last Name:CLARVIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1242
Mailing Address - Country:US
Mailing Address - Phone:212-996-9245
Mailing Address - Fax:914-693-0023
Practice Address - Street 1:1120 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1242
Practice Address - Country:US
Practice Address - Phone:212-996-9245
Practice Address - Fax:914-693-0023
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-02
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1643802084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry