Provider Demographics
NPI:1679698187
Name:HAUER, SUZANA (PSYD)
Entity type:Individual
Prefix:
First Name:SUZANA
Middle Name:
Last Name:HAUER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SUZANA
Other - Middle Name:
Other - Last Name:GUARDIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:217 W 110TH ST
Mailing Address - Street 2:APT 12
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-4109
Mailing Address - Country:US
Mailing Address - Phone:646-637-8033
Mailing Address - Fax:
Practice Address - Street 1:133 E 95TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1723
Practice Address - Country:US
Practice Address - Phone:646-637-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018296103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical