Provider Demographics
NPI:1174715114
Name:SZOMBATHYNE MESZAROS, ZSUZSA (MD, PHD)
Entity type:Individual
Prefix:
First Name:ZSUZSA
Middle Name:
Last Name:SZOMBATHYNE MESZAROS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:ZSUZSA
Other - Middle Name:
Other - Last Name:MESZAROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:PBS 330
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2306
Mailing Address - Country:US
Mailing Address - Phone:315-464-1705
Mailing Address - Fax:315-464-1719
Practice Address - Street 1:321 W ONONDAGA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3207
Practice Address - Country:US
Practice Address - Phone:315-464-1705
Practice Address - Fax:315-464-1719
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2516432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03019156Medicaid