Phelan, Susan

Phelan, Susan is an sole proprietor health care provider with primary practice located at 640 Belle Terre Rd Suite J2-3, Port Jefferson NY 11777-1936. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Phelan, Susan can be contacted via phone (631) 928-3184.

Contact Information

Primary practice address
640 Belle Terre Rd Suite J2-3 Port Jefferson NY 11777-1936
Phone: (631) 928-3184
Fax: (631) 928-3957
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F4001481 New York

Profile Details

NPI number 1487711636
LBN Legal business name Phelan, Susan
Credentials PH D NP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2007
Last updated Jun 23rd, 2010 - about 14 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 1487711636 NPPES
New York MEDICAID 01570447

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