Provider Demographics
NPI:1770675167
Name:KRASNER, SUSAN STARR (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:STARR
Last Name:KRASNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 TRANSIT RD
Mailing Address - Street 2:STE B
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1427
Mailing Address - Country:US
Mailing Address - Phone:716-204-0100
Mailing Address - Fax:716-204-2761
Practice Address - Street 1:6507 TRANSIT RD
Practice Address - Street 2:STE B
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1427
Practice Address - Country:US
Practice Address - Phone:716-204-0100
Practice Address - Fax:716-204-2761
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010762103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000511230001OtherBC/BS WNY
NY00020351401OtherUNIVERA
NY6190235OtherINDEPENDENT HEALTH
NY000511230001OtherBC/BS WNY