Provider Demographics
NPI:1558520791
Name:DIETER, SUZANNE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:DIETER
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 1:577 1ST AVE
Mailing Address - Street 2:NYU CHILD STUDY CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6404
Mailing Address - Country:US
Mailing Address - Phone:212-263-4342
Mailing Address - Fax:
Practice Address - Street 1:577 1ST AVE
Practice Address - Street 2:NYU CHILD STUDY CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6404
Practice Address - Country:US
Practice Address - Phone:212-263-4342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2458062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry