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NPI Code Detail

MEDICARE: PROF. SUSAN JACOB CHERIAN NP

MEDICARE: PROF. SUSAN JACOB CHERIAN NP
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
1363LP0200XPediatric Nurse Practitioner380734NY

General Provider Information

NPI Number : 1982864906
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. SUSAN JACOB CHERIAN NP
Provider Business Mailing Address
First Line : 8 CLAUDIA CT
Second Line :
City : TAPPAN
State : NY
Zip : 10983-1936
Country : US
Telephone Number : 845-365-6741
Fax Number : 845-365-6741
Provider Business Practice Location Address
First Line : 48 NEW MAIN ST
Second Line :
City : HAVERSTRAW
State : NY
Zip : 10927-1812
Country : US
Telephone Number : 845-429-1680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2008
Last Update Date : 01/25/2013

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