Provider Demographics
NPI:1194937730
Name:HEIN, SUSAN
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:HEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2605
Mailing Address - Country:US
Mailing Address - Phone:212-799-5207
Mailing Address - Fax:
Practice Address - Street 1:140 RIVERSIDE DR
Practice Address - Street 2:14H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2605
Practice Address - Country:US
Practice Address - Phone:212-799-5207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000105102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst