Provider Demographics
NPI:1538145982
Name:DUNZ, SUSAN (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:DUNZ
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 1:1026 UNION RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3449
Mailing Address - Country:US
Mailing Address - Phone:716-712-0851
Mailing Address - Fax:716-712-0853
Practice Address - Street 1:1026 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3449
Practice Address - Country:US
Practice Address - Phone:716-712-0851
Practice Address - Fax:716-712-0853
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334639363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00027255901OtherUNIVERA
NY000560960001OtherBC/BS
NY9512861OtherIHA
NY02669405Medicaid
NY000560960001OtherBC/BS
NYRA8503Medicare PIN
P00339301Medicare PIN