Provider Demographics
NPI:1821193889
Name:YU, SUZANNE G (MD)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:G
Last Name:YU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 EAST 23RD STREET, STE 12M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4752
Mailing Address - Country:US
Mailing Address - Phone:848-863-8700
Mailing Address - Fax:732-387-0083
Practice Address - Street 1:730 58TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3917
Practice Address - Country:US
Practice Address - Phone:718-567-8808
Practice Address - Fax:212-423-5905
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226996-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02359011Medicaid
NYH82643Medicare UPIN
NY02359011Medicaid