Provider Demographics
NPI:1558529990
Name:MALTSER, SUSAN (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MALTSER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NORTHERN BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5321
Mailing Address - Country:US
Mailing Address - Phone:516-465-8609
Mailing Address - Fax:516-465-8723
Practice Address - Street 1:825 NORTHERN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5321
Practice Address - Country:US
Practice Address - Phone:516-465-8609
Practice Address - Fax:516-465-8723
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY602607208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation