Individual provider Active NPI

Susan Haselkorn, PHARMD

  • Nutrition Support Pharmacist
  • Riviera Beach, FL
National Provider Identifier
1497764278
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support PharmacistTaxonomy code 1835N1003X
License
PS35836 Issued in FL
Practice address
7305 N Military TRL
Riviera Beach, FL 33410-7417
Phone
(561) 422-7253
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Pharmacist 1835N1003X PS35836 FL Primary

Addresses

Primary practice location

7305 N Military TRL
Riviera Beach, FL 33410-7417

Mailing address

204 Glacier St
Palm Beach Gardens, FL 33410-1555
Phone (561) 422-7253

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS35836FLMDNutrition Support Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497764278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GLACIER ST",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101555",
            "telephone_number": "561-422-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 N MILITARY TRL",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334107417",
            "telephone_number": "561-422-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELKORN",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "FL",
            "license": "PS35836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.