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Marlo Suazo
Mobile Radiology Clinic/Center in Lake Grove, New York
NPI 1821412065

Marlo Suazo is a Mobile Radiology Clinic/Center based in Lake Grove, NY and is specialized in Radiology, Mobile. Marlo Suazo practices in Lake Grove, NY. The NPI Number for Marlo Suazo is 1821412065 and holds a License No. (New York).

The current practice location address for Marlo Suazo is 11 Bayard St, Lake Grove, NY and can be reached out via phone at 631-912-7476.

Location: 11 Bayard St, Lake Grove, NY, 11755-3147
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821412065
Provider Name
Marlo Suazo
Credential
Provider Entity Type
Individual
Gender
Male
Address
11 Bayard St, Lake Grove, NY, 11755-3147
Phone Number
631-912-7476
Fax Number
Provider Enumeration Date
02/07/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11 Bayard St
City
Lake Grove
State
New York
Zip
11755-3147
Phone Number
631-912-7476
Fax Number
person
Provider Business Mailing Address Details
Address
11 Bayard St
City
Lake Grove
State
New York
Zip
11755-3147
Phone Number
631-912-7476
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Radiology, Mobile
Taxonomy
261QR0208X
License No.
()
Definition
Definition to come...
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