Active NPI
Susan Nutakor-Doh, FNP
- Family Nurse Practitioner
- Forest Hills, NY
National Provider Identifier
1134414360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 336541
- Practice address
- 7502 Austin St
Forest Hills, NY 11375-6237 - Phone
- (718) 268-0719
- NPI assigned
- Jun 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 336541 | NY | Primary |
Addresses
Primary practice location
7502 Austin St
Forest Hills, NY 11375-6237
Mailing address
7502 Austin St
Forest Hills, NY 11375-6237
Phone (718) 268-0719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 336541 | NY | MD | Medical Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1134414360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7502 AUSTIN ST",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113756237",
"telephone_number": "718-268-0719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7502 AUSTIN ST",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113756237",
"telephone_number": "718-268-0719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUTAKOR-DOH",
"first_name": "SUSAN",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-15",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "336541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.