Provider Demographics
NPI:1861840951
Name:JOSEPH, SUSAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:ALRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:326 E 93RD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-1808
Mailing Address - Country:US
Mailing Address - Phone:347-557-4338
Mailing Address - Fax:
Practice Address - Street 1:133 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4802
Practice Address - Country:US
Practice Address - Phone:121-286-5237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692622163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse