Individual provider Active NPI

Suzanne Sullivan, LPN

  • Licensed Practical Nurse
  • Lindenhurst, NY
National Provider Identifier
1154757193
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
276254 Issued in NY
Practice address
119 N 9TH St
Lindenhurst, NY 11757-3747
Phone
(631) 987-2513
NPI assigned
Sep 23, 2013
Last updated
Sep 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 276254 NY Primary

Addresses

Primary practice location

119 N 9TH St
Lindenhurst, NY 11757-3747

Mailing address

119 N 9TH St
Lindenhurst, NY 11757-3747
Phone (631) 987-2513

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
276254NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1154757193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N 9TH ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117573747",
            "telephone_number": "631-987-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N 9TH ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117573747",
            "telephone_number": "631-987-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "276254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.