Individual provider Active NPI

Susan Surujdai Khemraj

  • Registered Nurse
  • Pelham, NY
National Provider Identifier
1487096830
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
589506-1 Issued in NY
Practice address
1028 Grant Ave
Pelham, NY 10803-3141
Phone
(914) 262-1445
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 589506-1 NY Primary

Addresses

Primary practice location

1028 Grant Ave
Pelham, NY 10803-3141

Mailing address

1028 Grant Ave
Pelham, NY 10803-3141
Phone (914) 262-1445

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
589506-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1487096830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 GRANT AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108033141",
            "telephone_number": "914-262-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 GRANT AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108033141",
            "telephone_number": "914-262-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEMRAJ",
        "first_name": "SUSAN",
        "middle_name": "SURUJDAI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "589506-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.