Susan Reandeau
Individual provider Active NPI Licensed Practical Nurse · Tupper Lake, NY
NPI 1821493073 · NPPES record last updated Oct 30, 2014
Key facts
- NPI
- 1821493073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 205348-1 (NY)
- Practice address
- 24 Blueberry Hill Rd
Tupper Lake, NY 12986-2528 - Phone
- (518) 359-9297
- NPI assigned
- Oct 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205348-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 205348-1 | NY | Yes |
Addresses
Primary practice location
24 Blueberry Hill Rd
Tupper Lake, NY 12986-2528
Mailing address
PO Box 861
Tupper Lake, NY 12986-0861
Other providers in Tupper Lake, NY
- Annmarie Munn
- Jacob Nashett
- Lisa M O' Connor
- Mikayla O'Connor
- Mary C Radimer
- Rehab Resources
- Lori A Richardson
- Rite Aid of New York Inc
- Deborah Roddy
- Claire Santerre
All providers in Tupper Lake, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.