Provider Demographics
NPI:1316904899
Name:BRENDZE, SUZANNE (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BRENDZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 EAST AVE
Mailing Address - Street 2:HUTHER HEALTH CLINIC, FLOOR 3
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-2638
Mailing Address - Country:US
Mailing Address - Phone:585-325-5100
Mailing Address - Fax:585-232-1275
Practice Address - Street 1:360 EAST AVE
Practice Address - Street 2:HUTHER HEALTH CLINIC, FLOOR 3
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-2638
Practice Address - Country:US
Practice Address - Phone:585-325-5100
Practice Address - Fax:585-232-1275
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010220446OtherBLUE CROSS BLUE SHIELD
NYCFP2204469WOtherWORKERS COMPENSATION
NY000498493001OtherHEALTHNOW
NY7217332OtherAETNA
NY02156132Medicaid
NYMDF926OtherPREFERRED CARE
NYP010220446OtherBLUE CHOICE
NYCC4973Medicare PIN
NYP010220446OtherBLUE CROSS BLUE SHIELD