Provider Demographics
NPI:1972777811
Name:JOSEPH D SUTTON MDPC
Entity Type:Organization
Organization Name:JOSEPH D SUTTON MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTTON,M.D.P.C.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-357-1821
Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5204
Mailing Address - Country:US
Mailing Address - Phone:845-357-1821
Mailing Address - Fax:845-357-1875
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 107
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5204
Practice Address - Country:US
Practice Address - Phone:845-357-1821
Practice Address - Fax:845-357-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105181174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW37121Medicare PIN