Provider Demographics
NPI:1922308576
Name:SUSSMAN, FELICE (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICE
Middle Name:
Last Name:SUSSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:GREENS FARMS
Mailing Address - State:CT
Mailing Address - Zip Code:06838-0016
Mailing Address - Country:US
Mailing Address - Phone:203-254-7009
Mailing Address - Fax:
Practice Address - Street 1:1400 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5527
Practice Address - Country:US
Practice Address - Phone:203-254-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine