Provider Demographics
NPI:1790775583
Name:GREENIDGE, SUZANNE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:GREENIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1303
Mailing Address - Country:US
Mailing Address - Phone:914-375-2800
Mailing Address - Fax:914-375-7329
Practice Address - Street 1:1020 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1303
Practice Address - Country:US
Practice Address - Phone:914-375-2800
Practice Address - Fax:914-375-7329
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191103207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology