Provider Demographics
NPI:1215708722
Name:SUSAN DAINS APRN
Entity type:Organization
Organization Name:SUSAN DAINS APRN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAINS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-510-1037
Mailing Address - Street 1:241 ALBANY TPKE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2512
Mailing Address - Country:US
Mailing Address - Phone:860-609-2720
Mailing Address - Fax:
Practice Address - Street 1:241 ALBANY TPKE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2512
Practice Address - Country:US
Practice Address - Phone:860-609-2720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health