Provider Demographics
NPI:1588842868
Name:NERF, SUSAN (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:NERF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CORPORATE PARK RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6562
Mailing Address - Country:US
Mailing Address - Phone:845-298-5000
Mailing Address - Fax:845-897-2083
Practice Address - Street 1:25 CORPORATE PARK RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-6562
Practice Address - Country:US
Practice Address - Phone:845-298-5000
Practice Address - Fax:845-897-2083
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015584-2225700000X
NY672805163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist