Sussanah Amude Diri I, REGISTERED NURSE

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

622211 Issued in NY

Practice address

1300 Waters PL
Bronx, NY 10461-2714

Phone

(929) 348-3774

NPI assigned

Nov 29, 2019

Last updated

Nov 29, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1740827518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612714",
            "telephone_number": "929-348-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612714",
            "telephone_number": "929-348-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRI",
        "first_name": "SUSSANAH",
        "middle_name": "AMUDE",
        "name_suffix": "I",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-29",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "622211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.