Provider Demographics
NPI:1104812718
Name:BRILLHART, SUSAN JEAN (MSN, RN, BC, CPNP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JEAN
Last Name:BRILLHART
Suffix:
Gender:F
Credentials:MSN, RN, BC, CPNP
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Other - First Name:
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Mailing Address - Street 1:515 PARK AVE
Mailing Address - Street 2:1G
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6912
Mailing Address - Country:US
Mailing Address - Phone:201-420-6963
Mailing Address - Fax:212-748-7457
Practice Address - Street 1:199 CHAMBERS ST
Practice Address - Street 2:S-782 BMCC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1044
Practice Address - Country:US
Practice Address - Phone:917-273-7726
Practice Address - Fax:212-748-7457
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY368209163WP0200X
NJ26NR06786500163WP0200X
NYF380906363LP0200X
NJ26NN06786500363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics