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Contact Information

SUSAN M GANNON, MD
455 PATROON CREEK BLVD.
SUITE 101
ALBANY, NY12206
 Phone: 518-438-0505
 Fax: 518-438-4517
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for SUSAN M GANNON · (Female)

NPI # 1063471209
Status Active
Credentials MD
Entity Individual
Enumeration date 03/17/2006
Last updated 01/29/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 234913-1
  • NY Medicaid 02685936
Hospital affiliation(s)
  • ST PETER'S HOSPITAL - (Acute Care)
    315 SOUTH MANNING BOULEVARD
    ALBANY, NY 12208
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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