Provider Demographics
NPI:1255692059
Name:HEALY, SUSAN (OSC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HEALY
Suffix:
Gender:F
Credentials:OSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 INDIAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566-5463
Mailing Address - Country:US
Mailing Address - Phone:845-744-5170
Mailing Address - Fax:
Practice Address - Street 1:34 JEANNE DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1701
Practice Address - Country:US
Practice Address - Phone:845-566-3419
Practice Address - Fax:845-566-3421
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator