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Susan Wortsman

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NPI Number Detailed Information

Provider Information:

Name: Susan Wortsman
Gender: F
Provider License Number If Given: 000396-1

NPI Information:

NPI: 1841293990
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 68 ROCKLEDGE RD APT 1C
Hartsdale, NY 10530
Phone Number: 2124814464
Fax Number:

Provider Business Practice Location Address:

Address: 425 E 25TH ST
New York, NY 10010
Phone Number: 2124814464
Fax Number:

Provider Taxonomy:

Primary: 231H00000X
Secondary (if any):
State: NY

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