Susan Jacob Cherian, NP

Individual provider Active NPI Pediatric Nurse Practitioner · Haverstraw, NY

NPI 1982864906 · NPPES record last updated Jan 25, 2013

Key facts

NPI
1982864906
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
380734 (NY)
Practice address
48 New Main St
Haverstraw, NY 10927-1812
Phone
(845) 429-1680
NPI assigned
Jun 12, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
380734NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blythedale Childrens Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 380734 NY Yes

Addresses

Primary practice location

48 New Main St
Haverstraw, NY 10927-1812

Mailing address

8 Claudia CT
Tappan, NY 10983-1936
Phone (845) 365-6741

Other providers in Haverstraw, NY

All providers in Haverstraw, NY · Pediatric Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.