Basic Information
| Provider Information | |||||||||
| NPI: | 1154683449 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CURTIS | ||||||||
| FirstName: | SUSANNA | ||||||||
| MiddleName: | ALTON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 CEDAR ST # 205 | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065103206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1203671815 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1470 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122416756 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2012 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 54106 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 54106 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RX0202X | 54106 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RX0202X | 306170 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.