Healthcare Provider Details

I. General information

NPI: 1518965409
Provider Name (Legal Business Name): SUSAN M HAMO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN M ZABEK FNP

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 GENESEE ST SUITE 200
UTICA NY
13501
US

IV. Provider business mailing address

2211 GENESEE ST SUITE 200
UTICA NY
13501
US

V. Phone/Fax

Practice location:
  • Phone: 315-733-7598
  • Fax: 315-733-7694
Mailing address:
  • Phone: 315-733-7598
  • Fax: 315-733-7694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF331297-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: