Provider Demographics
NPI:1821117649
Name:MULVIHILL, SUSAN (APN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:MULVIHILL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:FANELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:24 LENAPE TRL
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4412
Mailing Address - Country:US
Mailing Address - Phone:973-877-5300
Mailing Address - Fax:
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-273-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00047300363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care