Individual provider Active NPI

Suzanne Dale, PHD

  • Diplomate Laboratory Management Specialist/Technologist
  • Rochester, NY
National Provider Identifier
1790295061
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diplomate Laboratory Management Specialist/TechnologistTaxonomy code 246QL0901X
License
DALES3 Issued in NY
Practice address
160 Elmgrove Park
Rochester, NY 14624-1359
Phone
(585) 429-2360
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diplomate Laboratory Management Specialist/Technologist 246QL0901X DALES3 NY Primary

Addresses

Primary practice location

160 Elmgrove Park
Rochester, NY 14624-1359

Mailing address

810 Tinker Tavern Rd
Webster, NY 14580-8945
Phone (585) 787-4420

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 Philosophy

State licenses

LicenseStateTypeSpecialty
DALES3NYMDDiplomate Laboratory Management Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1790295061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 TINKER TAVERN RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145808945",
            "telephone_number": "585-787-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ELMGROVE PARK",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241359",
            "telephone_number": "585-429-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0901X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management, Diplomate",
            "state": "NY",
            "license": "DALES3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.