Individual
SUSAN E. DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-CNM
Contact information
Practice address
535 MAIN ST, OLEAN, NY 14760
(716) 372-0141
(716) 372-6421
Mailing address
535 MAIN ST, OLEAN, NY 14760
(716) 372-0141
(716) 372-6421
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
F420192
NY
367A00000X
Advanced Practice Midwife
Primary
F000461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01436364
—
NY
Enumeration date
02/07/2006
Last updated
06/15/2016
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