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Individual

ELLA S SUSSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 732-7419
Mailing address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 732-7419

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
113557
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2303338
MA

Other

Enumeration date
04/26/2014
Last updated
12/03/2015
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