Individual
SUSAN AIKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
9 4TH AVE, BAY SHORE, NY 11706-7908
(631) 665-6707
Mailing address
49 HIGGINS ST, NORTH BABYLON, NY 11703-3505
(631) 665-6707
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
00400788
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00400788
—
NY
Enumeration date
01/17/2007
Last updated
04/10/2012
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