Provider Demographics
NPI: | 1811951239 |
---|---|
Name: | SHEBELSKY, SUSAN Z (CRNA) |
Entity type: | Individual |
Prefix: | |
First Name: | SUSAN |
Middle Name: | Z |
Last Name: | SHEBELSKY |
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: | 68 S SERVICE RD |
Mailing Address - Street 2: | SUITE 350 |
Mailing Address - City: | MELVILLE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11747-2354 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 516-945-3000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 206 E BROWN ST |
Practice Address - Street 2: | NORTH AMERICAN PARTNERS IN ANESTHESIA, PA, LLC |
Practice Address - City: | E STROUDSBURG |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18301-3006 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-421-4000 |
Practice Address - Fax: | 570-476-3754 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-04-13 |
Last Update Date: | 2009-11-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | RN185046L | 367500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 0073876820003 | Medicaid | |
PA | 0073876820003 | Medicaid | |
PA | 005244PZP | Medicare ID - Type Unspecified |