Provider Demographics
NPI:1821114885
Name:ORINGEL, SUSAN ELLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ELLYN
Last Name:ORINGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1227
Mailing Address - Country:US
Mailing Address - Phone:518-439-0090
Mailing Address - Fax:518-439-0267
Practice Address - Street 1:200 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1227
Practice Address - Country:US
Practice Address - Phone:518-439-0090
Practice Address - Fax:518-439-0267
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7506-1103T00000X, 103TA0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7506-1OtherPSYCHOLOGIST LICENSE