Provider Demographics
NPI:1821379710
Name:LANGTRY, SUZANNE MARIE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:LANGTRY
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 E GENESEE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4131
Mailing Address - Country:US
Mailing Address - Phone:315-253-6796
Mailing Address - Fax:315-252-6354
Practice Address - Street 1:4939 BRITTONFIELD PARKWAY
Practice Address - Street 2:SUITE 211
Practice Address - City:E SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057
Practice Address - Country:US
Practice Address - Phone:315-446-4400
Practice Address - Fax:315-446-4201
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF421046-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health