Provider Demographics
NPI:1881784809
Name:SUTTON, MARILYN W (MD)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:W
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2 OVERHILL RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5323
Mailing Address - Country:US
Mailing Address - Phone:914-636-0077
Mailing Address - Fax:914-636-5116
Practice Address - Street 1:2 OVERHILL RD
Practice Address - Street 2:SUITE 225
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5323
Practice Address - Country:US
Practice Address - Phone:914-636-0077
Practice Address - Fax:914-636-5116
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-04-03
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Provider Licenses
StateLicense IDTaxonomies
NY231506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I25325PMedicare UPIN