Provider Demographics
NPI:1003961848
Name:HAMILL, SUSAN (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HAMILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:914-734-8800
Mailing Address - Fax:914-734-8786
Practice Address - Street 1:82 MIDDLE COUNTRY RD
Practice Address - Street 2:ELSIE OWENS HEALTH CENTER - HRHCARE, INC.
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-4411
Practice Address - Country:US
Practice Address - Phone:631-320-2200
Practice Address - Fax:631-698-8570
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380735363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02377695Medicaid
NY95N731Medicare ID - Type Unspecified
NY02377695Medicaid