Healthcare Provider Details

I. General information

NPI: 1366978207
Provider Name (Legal Business Name): SUZANNE LINGL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE ANDERS

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E 25TH ST
NEW YORK NY
10010-2936
US

IV. Provider business mailing address

77 ESTABAN DR
CAMARILLO CA
93010-1609
US

V. Phone/Fax

Practice location:
  • Phone: 646-713-0000
  • Fax:
Mailing address:
  • Phone: 707-343-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number404439
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: