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NPI Code Detail

MEDICARE: SUZANNA E WESER FNP

MEDICARE: SUZANNA E WESER FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse616634NY
2363LF0000XFamily Nurse Practitioner337182NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669746301
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNA E WESER FNP
Provider Business Mailing Address
First Line : 1200 DRIVING PARK AVE
Second Line :
City : NEWARK
State : NY
Zip : 14513-1057
Country : US
Telephone Number : 315-332-2406
Fax Number :
Provider Business Practice Location Address
First Line : 4425 OLD RIDGE RD
Second Line :
City : WILLIAMSON
State : NY
Zip : 14589-9363
Country : US
Telephone Number : 315-483-3280
Fax Number : 315-589-4893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2012
Last Update Date : 12/21/2022

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Directions to “ SUZANNA E WESER FNP” Practice Location

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