Provider Demographics
NPI:1225249824
Name:GUILD, SUSAN DORNEY (RN, MS, CPNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DORNEY
Last Name:GUILD
Suffix:
Gender:F
Credentials:RN, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1108
Mailing Address - Country:US
Mailing Address - Phone:718-524-4723
Mailing Address - Fax:
Practice Address - Street 1:53 KNIGHTSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3925
Practice Address - Country:US
Practice Address - Phone:973-865-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR03815700163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics