Provider Demographics
NPI:1669529210
Name:DANTO, SUSAN (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:DANTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10151 MONTGOMERY BLVD NE
Mailing Address - Street 2:STE 2C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3664
Mailing Address - Country:US
Mailing Address - Phone:505-262-9193
Mailing Address - Fax:505-265-7860
Practice Address - Street 1:7801 ACADEMY NE
Practice Address - Street 2:BLDG. 1, SUITE 202
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-262-9193
Practice Address - Fax:505-265-7860
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2016-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM97-372084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMB4546Medicaid