Suzanne S Ahn, MD
Individual provider Active NPI Pediatrics Physician · Brattleboro, VT
NPI 1982602637 · NPPES record last updated Sep 10, 2008
Key facts
- NPI
- 1982602637
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 042-0010611 (VT)
- Practice address
- 21 Belmont Ave
Brattleboro, VT 05301-7110 - Phone
- (802) 258-3905
- Fax
- (802) 258-4903
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0010611 | VT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care Health Partners - New York LLP | Pediatrics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 042-0010611 | VT | Yes |
Addresses
Primary practice location
21 Belmont Ave
Brattleboro, VT 05301-7110
Mailing address
600 Blair Park Rd
Suite 190
Williston, VT 05495-7586
Phone (802) 288-1145
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010020 | Medicaid | VT |
Other providers in Brattleboro, VT
- Samia J Abbass
- Peter John Abell
- Advanced Skin Care Solutions
- Zain U Ahmed
- Cheryl Anne Aiken
- Shumokh Abdullah S Alanazi
- Peter Albert
- David J Albright
- Alexandra Keep PLLC
All providers in Brattleboro, VT · Pediatrics Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.