Provider Demographics
NPI:1316377260
Name:EMPIRE OSTEOPATHY LLC
Entity type:Organization
Organization Name:EMPIRE OSTEOPATHY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SUESSLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:804-878-4869
Mailing Address - Street 1:332A CANOE PLACE ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968
Mailing Address - Country:US
Mailing Address - Phone:804-878-4869
Mailing Address - Fax:
Practice Address - Street 1:332A CANOE PLACE ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968
Practice Address - Country:US
Practice Address - Phone:804-878-4869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259627204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty