Jensen, Susan M

Jensen, Susan M is an individual health care provider with primary practice located at 2570 Route 9W Ste 4, Cornwall NY 12518-1323. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Jensen, Susan M can be contacted via phone (845) 534-1505.

Contact Information

Primary practice address
2570 Route 9W Ste 4 Cornwall NY 12518-1323
Phone: (845) 534-1505
Fax: (845) 534-1504
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 138024 New York

Profile Details

NPI number 1134185556
LBN Legal business name Jensen, Susan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Sep 27th, 2012 - about 13 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 1134185556 NPPES
Other 30A161L663 MEDICARE
MEDICAID 00510563 MEDICARE

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