Provider Demographics
NPI:1578608691
Name:NEUMANN, SUSANNA LEAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNA
Middle Name:LEAH
Last Name:NEUMANN
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 1:9 E 10TH ST
Mailing Address - Street 2:APT. 2R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5936
Mailing Address - Country:US
Mailing Address - Phone:212-255-7784
Mailing Address - Fax:
Practice Address - Street 1:80 UNIVERSITY PL
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4564
Practice Address - Country:US
Practice Address - Phone:212-255-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5080103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV63171Medicare ID - Type UnspecifiedPSYCHOLOGIST