Suslow, Gregory R.
Suslow, Gregory R. is an individual health care provider with primary practice located at 3401 N Broad St , Philadelphia PA 19140-5103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, which is considered as his primary health care specialty. Suslow, Gregory R. can be contacted via phone (215) 707-4353.Contact Information
Primary practice address
3401 N Broad St
Philadelphia PA 19140-5103
Phone: (215) 707-4353
Fax: (215) 707-2781
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | MD-050303-L | Pennsylvania |
Profile Details
| NPI number | 1417962176 |
|---|---|
| LBN Legal business name | Suslow, Gregory R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2006 |
| Last updated | Aug 20th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417962176 | NPPES |
| Pennsylvania | Other | 000449333 | BLUE CROSS |
| Pennsylvania | MEDICAID | 001437535 | BLUE CROSS |
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