Provider Demographics
NPI:1720333222
Name:RATAY, SUSAN MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:RATAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2131 LAKE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-3466
Mailing Address - Country:US
Mailing Address - Phone:440-964-3733
Mailing Address - Fax:440-964-7069
Practice Address - Street 1:2131 LAKE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-3466
Practice Address - Country:US
Practice Address - Phone:440-964-3733
Practice Address - Fax:440-964-7069
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-011399207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine