Organization Active NPI

Loubert S Suddaby MD PC

  • Neurological Surgery Physician
  • Orchard Park, NY
National Provider Identifier
1710164066
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
193722 Issued in NY
Legal business name
LOUBERT S SUDDABY MD PC
Practice address
3775 Southwestern Blvd
Suite a
Orchard Park, NY 14127-2159
Phone
(716) 667-1980
Fax
(716) 667-1982
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Authorized official

Name
Mrs. Susan L Whipple
Title
Office Manager
Phone
(716) 667-1980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 193722 NY Primary

Addresses

Primary practice location

3775 Southwestern Blvd
Suite a
Orchard Park, NY 14127-2159

Mailing address

3775 Southwestern Blvd
Suite a
Orchard Park, NY 14127-2159
Phone (716) 667-1980

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1710164066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 SOUTHWESTERN BLVD",
            "address_2": "SUITE A",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272159",
            "telephone_number": "716-667-1980",
            "fax_number": "716-667-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 SOUTHWESTERN BLVD",
            "address_2": "SUITE A",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272159",
            "telephone_number": "716-667-1980",
            "fax_number": "716-667-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUBERT S SUDDABY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "WHIPPLE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "716-667-1980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "193722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.