Provider Demographics
NPI:1194729921
Name:RINER, SUSAN G (ANP-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:RINER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 SUMMIT ST
Mailing Address - Street 2:STE 1
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1645
Mailing Address - Country:US
Mailing Address - Phone:585-343-4440
Mailing Address - Fax:585-343-0381
Practice Address - Street 1:229 SUMMIT ST
Practice Address - Street 2:STE 1
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1645
Practice Address - Country:US
Practice Address - Phone:585-343-4440
Practice Address - Fax:585-343-0381
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3025261363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01909920Medicaid
NY01909920Medicaid
NYCC5896Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID