Provider Demographics
NPI:1114780921
Name:MULLER, SUZAURA (LPN)
Entity Type:Individual
Prefix:
First Name:SUZAURA
Middle Name:
Last Name:MULLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8132 RIZZO DR
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13041-8889
Mailing Address - Country:US
Mailing Address - Phone:213-215-5750
Mailing Address - Fax:
Practice Address - Street 1:8132 RIZZO DR
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:NY
Practice Address - Zip Code:13041-8889
Practice Address - Country:US
Practice Address - Phone:213-215-5750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314390-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse