Individual
SUSAN H VACCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-5000
(212) 305-7400
Mailing address
300 S BROADWAY APT 1D, TARRYTOWN, NY 10591-5308
(914) 332-0618
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F380764
NY
Other
Enumeration date
03/09/2007
Last updated
08/23/2012
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