Provider Demographics
NPI:1730250853
Name:SURMAN, SUZANNE JANNINE (OD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:JANNINE
Last Name:SURMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2021
Mailing Address - Country:US
Mailing Address - Phone:215-287-8331
Mailing Address - Fax:
Practice Address - Street 1:1000 ROSS PARK MALL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3875
Practice Address - Country:US
Practice Address - Phone:412-366-9090
Practice Address - Fax:412-366-4549
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001488152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAV00646Medicare UPIN
PA081409Medicare ID - Type Unspecified