Provider Demographics
NPI:1871057372
Name:SUSAN SAMUEL CONSULTING INC.
Entity type:Organization
Organization Name:SUSAN SAMUEL CONSULTING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:BA
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PD,SAS,SDA,MSED
Authorized Official - Phone:917-324-7592
Mailing Address - Street 1:3025 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3024
Mailing Address - Country:US
Mailing Address - Phone:917-324-7592
Mailing Address - Fax:
Practice Address - Street 1:12722 HAWTREE CREEK RD STE 1
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-1632
Practice Address - Country:US
Practice Address - Phone:917-324-7592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUSAN SAMUEL CONSULTING INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty