Susan Maldonado, LPN
Individual provider Active NPI Licensed Practical Nurse · Springfield Center, NY
NPI 1386066009 · NPPES record last updated Jan 15, 2014
Key facts
- NPI
- 1386066009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 270555 (NY)
- Practice address
- 5178 US Highway 20
Springfield Center, NY 13468-2100 - Phone
- (607) 264-3193
- NPI assigned
- Jan 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 270555 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 270555 | NY | Yes |
Addresses
Primary practice location
5178 US Highway 20
Springfield Center, NY 13468-2100
Mailing address
PO Box 102
Richfield Springs, NY 13439-0102
Phone (607) 264-3193
Other providers in Springfield Center, NY
All providers in Springfield Center, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.