Provider Demographics
NPI:1558397505
Name:MARGOLIS, SUSAN GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:GAIL
Last Name:MARGOLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 E 34TH ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4974
Mailing Address - Country:US
Mailing Address - Phone:212-981-7260
Mailing Address - Fax:212-981-7295
Practice Address - Street 1:323 E 34TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4974
Practice Address - Country:US
Practice Address - Phone:212-981-7260
Practice Address - Fax:212-981-7295
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185693174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4203319OtherAETNA
NY01720043Medicaid
NY180042359OtherMEDICARE RAIL ROAD
NYP1113561OtherOXFORD
NY129319OtherWELLCARE
NY3C1603OtherHEALTHNET
NY94F76OtherEMPIRE BCBS
NYE94827Medicare UPIN
NYA400084181Medicare PIN
NY180042359OtherMEDICARE RAIL ROAD