MEDICARE: SUSAN PYLE GUIRY APN

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
1	363L00000X	Nurse Practitioner	26NJ00447800	NJ

General Provider Information

NPI Number	:	1912348954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN PYLE GUIRY APN

Provider Business Mailing Address
First Line	:	12 GREGORY AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-4030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 GREGORY AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-4030
Country	:	US
Telephone Number	:	973-325-0830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2013
Last Update Date	:	07/06/2013

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