Healthcare Provider Details

I. General information

NPI: 1427070663
Provider Name (Legal Business Name): SUSAN ARNOLD GUNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 MAIN ST SUITE 240
WILLIAMSVILLE NY
14221-5360
US

IV. Provider business mailing address

65 CHASSIN AVE
AMHERST NY
14226-4204
US

V. Phone/Fax

Practice location:
  • Phone: 716-626-9016
  • Fax: 716-262-4271
Mailing address:
  • Phone: 716-838-6156
  • Fax: 716-626-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400994
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: