Samuel S Sue

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

111606 Issued in NY

Practice address

1400 Noyes St
Utica, NY 13502-3854

Phone

(315) 797-6800

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184849101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JUNIPER LN",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NOYES ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135023854",
            "telephone_number": "315-797-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUE",
        "first_name": "SAMUEL",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "111606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111606",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omer Stupac I, MD
• Andrea C. Styles, LPN
• Sampath Subramaniam, M.D
• Sudershan Kumar Dang, Physician P.C.
• Sudhir C Potluri OB/GYN PC
• Suzana Sukunda
• Lisa Sullivan, N.P.
• Paige Nicole Sullivan
• Jennifer Ann Sumner, OTRL
• Sunset Anesthesia Associates LLP

• Psychiatry Physician in Utica, NY
• Providers in Utica, NY by specialty
• Psychiatry Physician in New York

• 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.

Verify at the official NPI Registry.