Provider Demographics
NPI:1790036267
Name:ENGEL, SUZANNE ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:ENGEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PARDEE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-2810
Mailing Address - Country:US
Mailing Address - Phone:585-339-1378
Mailing Address - Fax:
Practice Address - Street 1:600 PARDEE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-2810
Practice Address - Country:US
Practice Address - Phone:585-339-1378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018997103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool