Healthcare Provider Details

I. General information

NPI: 1821980335
Provider Name (Legal Business Name): SUSAN BROUGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 ROUTE 376
WAPPINGERS FALLS NY
12590-6483
US

IV. Provider business mailing address

34 MONROE DR
POUGHKEEPSIE NY
12601-6019
US

V. Phone/Fax

Practice location:
  • Phone: 845-486-2850
  • Fax: 845-486-2770
Mailing address:
  • Phone: 845-298-2955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number443905
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: