Provider Demographics
NPI:1548330764
Name:SCHNEIDERMESSER, SUSAN G (DPM)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:G
Last Name:SCHNEIDERMESSER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PROSPECT PARK WEST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215
Mailing Address - Country:US
Mailing Address - Phone:718-398-7593
Mailing Address - Fax:718-398-7594
Practice Address - Street 1:18 PROSPECT PARK WEST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-398-7593
Practice Address - Fax:718-398-7594
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004955213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN004955OtherLICENSE
NY01387764Medicaid
NY01387764Medicaid
U40693Medicare UPIN
NYN004955OtherLICENSE