Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 420155-1 | NY |
NPI | 1023160256 |
---|---|
Provider Name | Ms. Susan Orand |
First Address | Mamaroneck, NY 10543-1243 |
Second Address | New York, NY 10003-9502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |