Provider Demographics
NPI:1699909242
Name:KURIEN, SUSAN MATHEW (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MATHEW
Last Name:KURIEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 EAST ST
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2410
Mailing Address - Country:US
Mailing Address - Phone:845-680-4922
Mailing Address - Fax:845-680-5500
Practice Address - Street 1:32 EAST ST
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2410
Practice Address - Country:US
Practice Address - Phone:845-680-4922
Practice Address - Fax:845-680-5500
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist