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General NPI Number Information
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NPI Number | 1568842136
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Entity Type | Organization
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Legal Business Name | KATHLEEN SAM SUSSMAN
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 63 BRAMBACH ST APT 1
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City | SCARSDALE
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State | NY
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Zip | 10583-5202
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Country | US
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Telephone | 914-843-6126
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Fax |
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Provider Business Mailing Address
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Address Line | 63 BRAMBACH ST APT 1
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City | SCARSDALE
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State | NY
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Zip | 10583-5202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RN
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Name | KATHLEEN SAM SUSSMAN
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Credential |
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Telephone | 914-843-6126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 447044-1
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License Number State | NY
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