Provider Demographics
NPI:1184614174
Name:FLOWER, SUSANNE M (NP)
Entity type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:M
Last Name:FLOWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 W 190TH ST
Mailing Address - Street 2:#1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3937
Mailing Address - Country:US
Mailing Address - Phone:718-488-1059
Mailing Address - Fax:
Practice Address - Street 1:435 FORT WASHINGTON AVE
Practice Address - Street 2:ST FLOOR MEDICAL OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3506
Practice Address - Country:US
Practice Address - Phone:212-795-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301467363LA2200X
NY340260363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology