Susan Barnett

Individual provider Active NPI Licensed Practical Nurse · Ridge, NY

NPI 1982803029 · NPPES record last updated Jul 17, 2007

Key facts

NPI
1982803029
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
217249 (NY)
Practice address
54 Corchaug TRL
Ridge, NY 11961-2227
Phone
(631) 929-7229
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
217249NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 217249 NY Yes

Addresses

Primary practice location

54 Corchaug TRL
Ridge, NY 11961-2227

Mailing address

54 Corchaug TRL
Ridge, NY 11961-2227
Phone (631) 929-7229

Other identifiers

IdentifierTypeStateIssuer
01906505MedicaidNY

Other providers in Ridge, NY

All providers in Ridge, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.