Individual
SUSAN V BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
146 MANETTO HILL RD, PLAINVIEW, NY 11803-1308
(516) 931-2200
Mailing address
146 MANETTO HILL RD, PLAINVIEW, NY 11803-1308
(516) 931-2200
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382100
NY
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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