Provider Demographics
NPI:1629075908
Name:KRESSLY, SUSAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:KRESSLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1432 EASTON RD
Mailing Address - Street 2:SUITE 3-G
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2852
Mailing Address - Country:US
Mailing Address - Phone:215-343-5520
Mailing Address - Fax:215-343-5521
Practice Address - Street 1:1432 EASTON RD
Practice Address - Street 2:SUITE 3-G
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2852
Practice Address - Country:US
Practice Address - Phone:215-343-5520
Practice Address - Fax:215-343-5521
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2016-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039810E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE37331Medicare UPIN