Provider Demographics
NPI:1942678578
Name:SUAREZ, VERONICA ELIZABETH (PA)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:ELIZABETH
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3107
Mailing Address - Country:US
Mailing Address - Phone:646-510-0854
Mailing Address - Fax:
Practice Address - Street 1:2347 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3107
Practice Address - Country:US
Practice Address - Phone:646-510-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019010363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant