Susan J Bolton, RN

Individual provider Active NPI School Registered Nurse · Chestertown, NY

NPI 1396014775 · NPPES record last updated Dec 14, 2011

Key facts

NPI
1396014775
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
332492-1 (NY)
Practice address
6110 State Route 8
Chestertown, NY 12817-2417
Phone
(518) 494-3015
Fax
(518) 494-4601
NPI assigned
Dec 14, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
332492-1NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Warren Central School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 332492-1 NY Yes

Addresses

Primary practice location

6110 State Route 8
Chestertown, NY 12817-2417

Mailing address

6110 State Route 8
Chestertown, NY 12817-2417
Phone (518) 494-3015

Other providers in Chestertown, NY

All providers in Chestertown, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.