MEDICARE: SUZETTE COMPAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	51132901	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275279606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZETTE COMPAS

Provider Business Mailing Address
First Line	:	1145 E 35TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4241
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 E 35TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4241
Country	:	US
Telephone Number	:	347-299-8403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2022
Last Update Date	:	05/09/2022

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Directions to “ SUZETTE COMPAS ” Practice Location

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