Provider Demographics
NPI:1588944623
Name:ALTEMA-BENOIT, SUZETTE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:SUZETTE
Middle Name:
Last Name:ALTEMA-BENOIT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 W VALLEY STREAM BLVD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5317
Mailing Address - Country:US
Mailing Address - Phone:347-731-2578
Mailing Address - Fax:
Practice Address - Street 1:327 W VALLEY STREAM BLVD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5317
Practice Address - Country:US
Practice Address - Phone:347-731-2578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-21
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily