Healthcare Provider Details

I. General information

NPI: 1669878138
Provider Name (Legal Business Name): SUSAN ZUK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2014
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LANCASTER AVE CANCER CENTER OF PAOLI HOSPITAL
PAOLI PA
19301-1763
US

IV. Provider business mailing address

255 W LANCASTER AVE CANCER CENTER OF PAOLI HOSPITAL
PAOLI PA
19301-1763
US

V. Phone/Fax

Practice location:
  • Phone: 484-565-1600
  • Fax: 610-647-2006
Mailing address:
  • Phone: 484-565-1600
  • Fax: 610-647-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP011295
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: