Healthcare Provider Details

I. General information

NPI: 1184699670
Provider Name (Legal Business Name): SUSAN MURAWSKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 E MAIN ST
WESTFIELD NY
14787-1121
US

IV. Provider business mailing address

138 E MAIN ST PO BOX10
WESTFIELD NY
14787-1121
US

V. Phone/Fax

Practice location:
  • Phone: 716-326-4678
  • Fax: 716-326-4914
Mailing address:
  • Phone: 716-326-4678
  • Fax: 716-326-4914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332342
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: