Provider Demographics
NPI:1124577978
Name:GAY, SUSAN S (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:S
Last Name:GAY
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GRAVEL HILL LN
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9025
Mailing Address - Country:US
Mailing Address - Phone:585-330-4961
Mailing Address - Fax:
Practice Address - Street 1:23 GRAVEL HILL LN
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-9025
Practice Address - Country:US
Practice Address - Phone:585-330-4961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY424236163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics