Healthcare Provider Details

I. General information

NPI: 1194729921
Provider Name (Legal Business Name): SUSAN G RINER ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 SUMMIT ST STE 1
BATAVIA NY
14020-1645
US

IV. Provider business mailing address

229 SUMMIT ST STE 1
BATAVIA NY
14020-1645
US

V. Phone/Fax

Practice location:
  • Phone: 585-343-4440
  • Fax: 585-343-0381
Mailing address:
  • Phone: 585-343-4440
  • Fax: 585-343-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3025261
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: