Provider Demographics
NPI:1518553700
Name:MARIANO, SUZANNE (FNP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:MARIANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SANDRA LN
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2837
Mailing Address - Country:US
Mailing Address - Phone:781-534-5048
Mailing Address - Fax:
Practice Address - Street 1:77 PONDFIELD RD STE 23
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-337-4986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily