Provider Demographics
NPI:1124711387
Name:PERRIE, SUZANNE (RD)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:PERRIE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 W 5TH ST APT 14S
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3844
Mailing Address - Country:US
Mailing Address - Phone:618-381-5645
Mailing Address - Fax:
Practice Address - Street 1:745 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10151-0099
Practice Address - Country:US
Practice Address - Phone:640-470-6420
Practice Address - Fax:855-817-0064
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered