Susan V. Estrada, MD, PC
Organization Active NPI Internal Medicine Physician · Transfer, PA
NPI 1164558433 · NPPES record last updated Nov 19, 2007
Key facts
- NPI
- 1164558433
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD 062293 L (PA)
- Legal business name
- SUSAN V. ESTRADA, MD, PC
- Practice address
- 239 Edgewood Drive Extension
Transfer, PA 16154 - Phone
- (724) 646-0400
- NPI assigned
- Feb 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Susan Victoria Estrada-Te
- Title
- Administrator
- Phone
- (724) 347-0861
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100525000308 | PA | Part B Supplier - Clinic/Group Practice | 9830228196 |
Receives reassigned benefits from 1 practitioner Practice locations: Farrell, PA; Franklin, PA; Greenville, PA; Transfer, PA |
National Provider Directory
Locations
2120 Likens Ln
Ste 2
Farrell, PA 16121
Phone (724) 983-7970
6885 US 322
Ste 4
Franklin, PA 16323
Phone (814) 678-6913
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | MD 062293 L | PA | Yes |
Addresses
Primary practice location
239 Edgewood Drive Extension
Transfer, PA 16154
Mailing address
13 Stoney Brook Blvd
Greenville, PA 16125-7803
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016769370007 | Medicaid | PA |
Other providers in Transfer, PA
- Tracey Lynn Rusnak
- SBW Pharmacy, Inc.
- Shenango Valley Anesthesia Inc
- John Sonoga
- Surgery Center at Edgewood Place, LLC
- Transfer Pharmacy Inc
- Jeffrey L. Watts
- Delia Salazer Wiles
- Monique Rose Zacherl
All providers in Transfer, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.