Provider Demographics
NPI:1396775276
Name:CAMBRIA, SUSAN KATHRYN (CRNA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KATHRYN
Last Name:CAMBRIA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 BROADVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2167
Mailing Address - Country:US
Mailing Address - Phone:203-876-0575
Mailing Address - Fax:
Practice Address - Street 1:576 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2167
Practice Address - Country:US
Practice Address - Phone:203-876-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTAPRN000606367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered