Provider Demographics
NPI:1912167586
Name:OGE, SUZE (LPN)
Entity Type:Individual
Prefix:
First Name:SUZE
Middle Name:
Last Name:OGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17032 130TH AVE APT 11D
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-6014
Mailing Address - Country:US
Mailing Address - Phone:718-528-4630
Mailing Address - Fax:
Practice Address - Street 1:17032 130TH AVE APT 11D
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-6014
Practice Address - Country:US
Practice Address - Phone:718-528-4630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271748-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse