Healthcare Provider Details

I. General information

NPI: 1497533954
Provider Name (Legal Business Name): SUZETTE KURA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 INTERVALE AVE
BRONX NY
10459-4240
US

IV. Provider business mailing address

900 INTERVALE AVE
BRONX NY
10459-4240
US

V. Phone/Fax

Practice location:
  • Phone: 718-732-7171
  • Fax: 718-732-7183
Mailing address:
  • Phone:
  • Fax: 718-732-7183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number310205
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: