Susan De Vivio, N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

292543 Issued in NY

Practice address

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Phone

(516) 572-6177

NPI assigned

Jun 30, 2006

Last updated

Apr 10, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1750310116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VIVIO",
        "first_name": "SUSAN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "292543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02724541",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shashikar Dayal, M.D.
• Kaye De Gracia, CRNA
• Josephine De la Rosa, M.D.
• Jayson Charles De Lucia, PA-C
• Allison De Seve, PHD
• Sabrina Deangelis
• Anthony Decicco
• Juliana Deeb, RPH
• David John Defilippis, DPT
• Michael Charles Defilippis, D.D.S.

• Pediatric Nurse Practitioner in East Meadow, NY
• Providers in East Meadow, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.