Basic Information
| Provider Information | |||||||||
| NPI: | 1831195239 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REGISFORD | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | HEATHER DAUN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 1436 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101631436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129830246 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 380 2ND AVE | ||||||||
| Address2: | CONCOURSE A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100105615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123751065 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2005 | ||||||||
| LastUpdateDate: | 06/17/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 186806 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.