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SHIDONG SU, MD,PC
NPI 1467542530
Psychiatry & Neurology - Neurology in Flushing, NY

Active since October 12, 2006
13621 ROOSEVELT AVE, SUITE 305, FLUSHING, NY 11354(718) 888-1803(718) 888-0957 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shidong Su, Md,pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHIDONG SU, MD,PC (NPI 1467542530) is a healthcare organization registered as a neurology in Flushing, New York and active in the NPI registry since October 2006. The organization lists Shidong Su, Director, as its authorized official.

NPPES Registry Identity

NPI1467542530
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameSHIDONG SU, MD,PC
Location Address13621 ROOSEVELT AVE, SUITE 305Flushing, NY 11354-5507
Mailing Address13621 Roosevelt Ave, Suite 305Flushing, NY 11354-5507 · (718) 888-1803 · Fax (718) 888-0957
Phone(718) 888-1803
Fax(718) 888-0957
Organization SubpartNo
Authorized OfficialShidong SuDirector · (718) 888-1803
Enumeration DateOctober 12, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1467542530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in NY · 215043
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
13621 ROOSEVELT AVE, Flushing, NY 11354
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Other Identifiers 2

Other05353NY · Ghi-medicare
Medicaid02159286NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAO & CHEN LLP
Internal Medicine
13621 ROOSEVELT AVE, SUITE 205
FLUSHING, NY 11354
Queens County (718) 353-2536
CYNTHIA STICH PT P.C.
Physical Therapist
13621 ROOSEVELT AVE, STE 409
FLUSHING, NY 11354
Queens County (718) 888-9778
CAO & CHEN MEDICAL LLP
Internal Medicine
13621 ROOSEVELT AVE, SUITE 205
FLUSHING, NY 11354
Queens County (718) 353-2536
DEEPMALA VASDEWANI
Physical Therapist
13621 ROOSEVELT AVE, SUITE-409,
FLUSHING, NY 11354
Queens County (718) 888-9778
DR. YUPING CHEN MD
Internal Medicine
13621 ROOSEVELT AVE, SUITE 205
FLUSHING, NY 11354
Queens County (718) 353-2536
SANJEEV AGARWAL MD PC
Specialist
13621 ROOSEVELT AVE, STE 409
FLUSHING, NY 11354
Queens County (718) 888-9778

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shidong Su, Md,pc's NPI number?

The NPI number for Shidong Su, Md,pc is 1467542530. It was assigned to this organization in the NPPES registry on October 12, 2006.

Where is Shidong Su, Md,pc located?

Shidong Su, Md,pc is located at 13621 Roosevelt Ave Suite 305, Flushing, NY 11354. The listed phone number is (718) 888-1803.

What is Shidong Su, Md,pc's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

When was this NPI record last updated?

The NPPES record for Shidong Su, Md,pc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.