Provider Demographics
NPI:1366756066
Name:WARE, SUSAN J (MS, RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:WARE
Suffix:
Gender:F
Credentials:MS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 STORER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-3119
Mailing Address - Country:US
Mailing Address - Phone:914-576-6198
Mailing Address - Fax:914-576-6198
Practice Address - Street 1:16 E 40TH ST FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0113
Practice Address - Country:US
Practice Address - Phone:212-307-7107
Practice Address - Fax:212-307-2308
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY497156-1163WA2000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health