# MS. SUSAN E. CEROVSKI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891771622
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | MED-PAC-LIC-36129 | MT | Yes |

## Other

- **Enumeration date:** 12/22/2005
- **Last updated:** 12/08/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 977217 | — | AZ |
| 01 | — | P00457896 | RAILROAD MEDICARE | AZ |