Provider Demographics
NPI:1124229455
Name:BAYERL, SUSAN BENEDICT (RN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BENEDICT
Last Name:BAYERL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:LYNNE
Other - Last Name:BAYERL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:138 CASTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2617
Mailing Address - Country:US
Mailing Address - Phone:716-668-6451
Mailing Address - Fax:
Practice Address - Street 1:2128 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1910
Practice Address - Country:US
Practice Address - Phone:716-874-5600
Practice Address - Fax:716-874-0388
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327856163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse