Provider Demographics
NPI:1083091599
Name:HRUBES, SUZANNE LISA (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LISA
Last Name:HRUBES
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 1:174 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5832
Mailing Address - Country:US
Mailing Address - Phone:631-838-3830
Mailing Address - Fax:
Practice Address - Street 1:174 BROOK ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5832
Practice Address - Country:US
Practice Address - Phone:631-838-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550922-1163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development