Provider Demographics
NPI:1124345913
Name:MAYER, SUSAN LEE (EDD, RN-BC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LEE
Last Name:MAYER
Suffix:
Gender:F
Credentials:EDD, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3424 KOSSUTH AVENUE
Mailing Address - Street 2:NORTH CENTRAL BRONX HOSPITAL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-515-1438
Mailing Address - Fax:718-519-3141
Practice Address - Street 1:3424 KOSSUTH AVENUE
Practice Address - Street 2:NORTH CENTRAL BRONX HOSPITAL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-515-1438
Practice Address - Fax:718-519-3141
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY202723163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator