Provider Demographics
NPI:1336187822
Name:KAPLAN, SUSAN SUFKA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:SUFKA
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:ANN
Other - Last Name:SUFKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1320
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:1233 LOCUST ST FL 5
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5453
Practice Address - Country:US
Practice Address - Phone:215-985-4448
Practice Address - Fax:215-732-5490
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174091201Medicaid
TX8D5451Medicare ID - Type Unspecified
TX174091201Medicaid