Individual provider Active NPI

Susan Mary Egan, APN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Cedar Knolls, NJ
National Provider Identifier
1922060334
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
26NJ00080900 Issued in NJ
Practice address
100 E Hanover Ave
Cedar Knolls, NJ 07927-2020
Phone
(973) 401-2121
Fax
(973) 625-7116
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 26NJ00080900 NJ Primary

Addresses

Primary practice location

100 E Hanover Ave
Cedar Knolls, NJ 07927-2020

Mailing address

94 Pleasant Hill Rd
Randolph, NJ 07869-3466
Phone (973) 927-3597

Other identifiers 1

IdentifierTypeStateIssuer
P00195000OtherNHCDS#

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00080900NJMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922060334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 PLEASANT HILL RD",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078693466",
            "telephone_number": "973-927-3597",
            "fax_number": "973-401-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E HANOVER AVE",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272020",
            "telephone_number": "973-401-2121",
            "fax_number": "973-625-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NJ00080900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS#",
            "identifier": "P00195000",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.