Provider Demographics
NPI:1598983850
Name:PULLING, SUSAN REMMER (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:REMMER
Last Name:PULLING
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:MARIE
Other - Last Name:REMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:3100 CHEN COURT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HTS
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1972
Mailing Address - Country:US
Mailing Address - Phone:914-302-6663
Mailing Address - Fax:
Practice Address - Street 1:91 SMITH AVENUE
Practice Address - Street 2:
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2810
Practice Address - Country:US
Practice Address - Phone:914-666-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001510-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
4657626OtherAETNA
P2650995OtherOXFORD HEALTH PLANS