Crandall, Susan Elaine
Crandall, Susan Elaine is an sole proprietor health care provider with primary practice located at 5304 Rincon Rd Nw , Albuquerque NM 87105-1763. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Crandall, Susan Elaine can be contacted via phone (505) 836-5047.Contact Information
Primary practice address
5304 Rincon Rd Nw
Albuquerque NM 87105-1763
Phone: (505) 836-5047
Fax: (505) 883-3938
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 1414 | New Mexico |
Profile Details
| NPI number | 1164629598 |
|---|---|
| LBN Legal business name | Crandall, Susan Elaine |
| Credentials | OT-L |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164629598 | NPPES |
| New Mexico | MEDICAID | 000L3936 |
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