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General NPI Number Information
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NPI Number | 1013054808
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Entity Type | Individual
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Provider Name | SUSAN T CAVANAGH N.P., C.N.M.
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 1985 CROMPOND RD BUILDING B
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-4146
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Country | US
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Telephone | 914-739-1697
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Fax | 914-739-0973
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Provider Business Mailing Address
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Address Line | 1985 CROMPOND RD
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-4146
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Country | US
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Telephone | 914-739-1697
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Fax | 914-739-0973
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 277534-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | F360158-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | F000117-1
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License Number State | NY
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