Provider Demographics
NPI:1033513882
Name:SUSSMAN, YOCHEVED (MST)
Entity type:Individual
Prefix:
First Name:YOCHEVED
Middle Name:
Last Name:SUSSMAN
Suffix:
Gender:F
Credentials:MST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2502
Mailing Address - Country:US
Mailing Address - Phone:845-352-1861
Mailing Address - Fax:
Practice Address - Street 1:5 BRIARCLIFF DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2502
Practice Address - Country:US
Practice Address - Phone:845-352-1861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2657257174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist