Provider Demographics
NPI:1992087829
Name:TSO, SUSAN (PHARM D)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:TSO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:LO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:401 PARK AVE S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-213-9730
Mailing Address - Fax:
Practice Address - Street 1:401 PARK AVE S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-213-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist