Active NPI
Susan Stillman, M.D.
- Developmental - Behavioral Pediatrics Physician
- Great Neck, NY
National Provider Identifier
1013094481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 160554
- Practice address
- 15 Barstow Rd
Great Neck, NY 11021-2229 - Phone
- (516) 482-4726
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 160554 | NY | Primary |
Addresses
Primary practice location
15 Barstow Rd
Great Neck, NY 11021-2229
Mailing address
80 Baker Hill Rd
Great Neck, NY 11023-1527
Phone (516) 829-8087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160554 | NY | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013094481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 BAKER HILL RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231527",
"telephone_number": "516-829-8087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BARSTOW RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212229",
"telephone_number": "516-482-4726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLMAN",
"first_name": "SUSAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "NY",
"license": "160554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.