De Vivio, Susan

De Vivio, Susan is an sole proprietor health care provider with primary practice located at 2201 Hempstead Tpke , East Meadow NY 11554-1859. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. De Vivio, Susan can be contacted via phone (516) 572-6177.

Contact Information

Primary practice address
2201 Hempstead Tpke East Meadow NY 11554-1859
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 292543 New York

Profile Details

NPI number 1750310116
LBN Legal business name De Vivio, Susan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2006
Last updated Apr 10th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750310116 NPPES
New York MEDICAID 02724541

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