Basic Information
Provider Information
NPI: 1881848794
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FENSKE
FirstName: SUZANNE
MiddleName: SILVERMAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SILVERMAN
OtherFirstName: SUZANNE
OtherMiddleName: KESSLER
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 5 E 98TH ST
Address2: SECOND FLOOR
City: NEW YORK
State: NY
PostalCode: 100296501
CountryCode: US
TelephoneNumber: 2122417952
FaxNumber:  
Practice Location
Address1: 5 E 98TH ST
Address2: SECOND FLOOR
City: NEW YORK
State: NY
PostalCode: 100296501
CountryCode: US
TelephoneNumber: 2122417952
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/06/2008
LastUpdateDate: 01/08/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X261212NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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