Susan Marie Noll, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

F360052 Issued in NY

Practice address

3001 Expressway Dr N
112
Islandia, NY 11749-5301

Phone

(631) 435-4322

Fax

(631) 435-3423

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• County of Suffolk

  • Methadone Clinic
  • Smithtown, NY
  • NPI 1649374851
  NPD (past)
• County of Suffolk

  dba Brentwood Family Health Center

  • Clinic/Center
  • Brentwood, NY
  • NPI 1851321152
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1467543298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EXPRESSWAY DR N",
            "address_2": "112",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495301",
            "telephone_number": "631-435-4322",
            "fax_number": "631-435-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EXPRESSWAY DR N",
            "address_2": "112",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495301",
            "telephone_number": "631-435-4322",
            "fax_number": "631-435-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F360052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02001581",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• National Medtrans, LLC (National Medtrans Network)
• Leticia Nazaire, ANP
• New York Wellness Massage PC
• Katie Newman
• Craig J Niederberger, RPH
• North Shore - Lij Pediatrics of Suffolk County, P.C.
• North Shore Lij OB GYN PC
• Northside Primary Medical Care PC
• Howard Novotny, M.D.
• Nu-Tech Health Care Services, LTD

• Obstetrics & Gynecology Nurse Practitioner in Islandia, NY
• Providers in Islandia, NY by specialty
• Obstetrics & Gynecology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.