Distasio, Susan A

Distasio, Susan A is an individual health care provider with primary practice located at One Medical Center Drive Dartmouth Hitchcock - Pain Medicine/Anesthesiology, Lebanon NH 03756-0001. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Oncology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Distasio, Susan A can be contacted via phone (603) 650-6039.

Contact Information

Primary practice address
One Medical Center Drive Dartmouth Hitchcock - Pain Medicine/Anesthesiology Lebanon NH 03756-0001
Phone: (603) 650-6039
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 064077-23 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Oncology 364SX0200X 001896 Connecticut

Profile Details

NPI number 1316975469
LBN Legal business name Distasio, Susan A
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated May 9th, 2017 - about 7 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 1316975469 NPPES
Connecticut MEDICAID 4196368

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