Provider Demographics
NPI:1548593676
Name:HATFIELD, SUZANNE (RPH)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LOOP RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3635
Mailing Address - Country:US
Mailing Address - Phone:315-255-1156
Mailing Address - Fax:315-255-0847
Practice Address - Street 1:1 LOOP RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3635
Practice Address - Country:US
Practice Address - Phone:315-255-1156
Practice Address - Fax:315-255-0847
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY049964OtherPHARMACIST LICENSE NUMBER