Provider Demographics
NPI:1477647402
Name:AARON, SUSAN T (CRNA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:T
Last Name:AARON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3998 FAIR RIDGE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3331
Practice Address - Street 1:2501 PARKERS LN
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3209
Practice Address - Country:US
Practice Address - Phone:703-664-7049
Practice Address - Fax:703-295-9369
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166006367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1477647402Medicaid
VA300836OtherAMERIGROUP
VA484645OtherNCPPO
VA139230OtherANTHEM
DCK142-0002OtherCAREFIRST
DCK142-0002OtherCAREFIRST
VA484645OtherNCPPO