Provider Demographics
NPI:1699933218
Name:ALYSSA SUSSMAN MD PA
Entity type:Organization
Organization Name:ALYSSA SUSSMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:TURK
Authorized Official - Last Name:SUSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-742-3929
Mailing Address - Street 1:2800 S SEACREST BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7960
Mailing Address - Country:US
Mailing Address - Phone:561-742-3929
Mailing Address - Fax:561-742-3931
Practice Address - Street 1:2800 S SEACREST BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7960
Practice Address - Country:US
Practice Address - Phone:561-742-3929
Practice Address - Fax:561-742-3931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71888204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty