Provider Demographics
NPI:1568161552
Name:GALLANT, SUZANNE MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MARIE
Last Name:GALLANT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:770 SAINT MARKS AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3733
Mailing Address - Country:US
Mailing Address - Phone:617-417-3800
Mailing Address - Fax:
Practice Address - Street 1:2811 QUEENS PLZ N # NA
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4172
Practice Address - Country:US
Practice Address - Phone:718-391-8300
Practice Address - Fax:111-111-1111
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY856094163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool