Provider Demographics
NPI:1831311737
Name:EPSTEIN, SUSAN L (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 VANDERBILT ST.
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:917-945-9002
Mailing Address - Fax:212-414-1807
Practice Address - Street 1:643 VANDERBILT ST.
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:917-945-9002
Practice Address - Fax:212-414-1807
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP471803OtherOXFORD ID #
NYCO4699-7OtherWORKERS' COMP
NYX28391Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
NYCO4699-7OtherWORKERS' COMP