Provider Demographics
NPI:1548391998
Name:BEDNAREK, SUZANNE L (CRNA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:L
Last Name:BEDNAREK
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 1:3614 HENNEBERRY RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-8600
Mailing Address - Country:US
Mailing Address - Phone:315-682-2833
Mailing Address - Fax:
Practice Address - Street 1:225 GREENFIELD PKWY STE 105
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-6656
Practice Address - Country:US
Practice Address - Phone:315-451-6911
Practice Address - Fax:315-451-1540
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298749367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA6121Medicare ID - Type Unspecified