Provider Demographics
NPI:1417028754
Name:ALBRIGHT, SUZANNE (NP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LONG POND RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1177
Mailing Address - Country:US
Mailing Address - Phone:585-368-4352
Mailing Address - Fax:
Practice Address - Street 1:1100 LONG POND RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1177
Practice Address - Country:US
Practice Address - Phone:585-368-4352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02394181Medicaid
NYCC9325 - 70008A GRPMedicare PIN
NY02394181Medicaid
NYRA4344-BA0017 GRPMedicare PIN