Provider Demographics
NPI:1831178425
Name:MEYERS, SUZANNE JANE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:JANE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 SHERIDAN DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AMHEARST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-831-0102
Mailing Address - Fax:716-831-0800
Practice Address - Street 1:3580 SHERIDAN DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-831-0102
Practice Address - Fax:716-831-0800
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1674521207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0707219OtherINDEPENDENT HEALTH
NY00010117901OtherUNIVERA
D01504Medicare UPIN
042883Medicare ID - Type Unspecified