Provider Demographics
NPI:1932460086
Name:USN
Entity Type:Organization
Organization Name:USN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBMARINE
Authorized Official - Prefix:
Authorized Official - First Name:SUSANO
Authorized Official - Middle Name:MICHEL
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:IDC
Authorized Official - Phone:904-214-6030
Mailing Address - Street 1:159 CHARTER OAK DR
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-2908
Mailing Address - Country:US
Mailing Address - Phone:904-214-6030
Mailing Address - Fax:
Practice Address - Street 1:159 CHARTER OAK DR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-2908
Practice Address - Country:US
Practice Address - Phone:904-214-6030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital