Provider Demographics
NPI:1548360886
Name:DAMBEK, SUZANNE (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:DAMBEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 WEST RIVER STREET
Mailing Address - Street 2:SUITE 11C
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904
Mailing Address - Country:US
Mailing Address - Phone:401-606-3000
Mailing Address - Fax:401-331-8110
Practice Address - Street 1:146 WEST RIVER STREET
Practice Address - Street 2:SUITE 11C
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904
Practice Address - Country:US
Practice Address - Phone:401-606-3000
Practice Address - Fax:401-331-8110
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD9757207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology