Provider Demographics
NPI:1508925975
Name:UYSAL, SUZAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:
Last Name:UYSAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2523
Mailing Address - Country:US
Mailing Address - Phone:914-238-1830
Mailing Address - Fax:914-239-3557
Practice Address - Street 1:701 N BROADWAY
Practice Address - Street 2:PHELPS MEMORIAL HOSPITAL CENTER
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1020
Practice Address - Country:US
Practice Address - Phone:914-238-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012201-1103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7248733OtherAETNA PROVIDER NUMBER
NYS54120Medicare UPIN
NY7248733OtherAETNA PROVIDER NUMBER
NYV9313VW051Medicare PIN