Provider Demographics
NPI:1659514107
Name:KERLINSKY, SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KERLINSKY
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 1:7104 FORT HAMILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1106
Mailing Address - Country:US
Mailing Address - Phone:718-238-2100
Mailing Address - Fax:
Practice Address - Street 1:7104 FORT HAMILTON PKWY
Practice Address - Street 2:COMPREHENSIVE GERIATRIC MEDICINE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-1106
Practice Address - Country:US
Practice Address - Phone:718-238-2100
Practice Address - Fax:718-748-0863
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400048252Medicare PIN