Individual
MS. SUSAN ROGGEN TANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, NP
Contact information
Practice address
1400 PELHAM PARKWAY SOUTH, BUILDING 1 3 WEST 7, BRONX, NY 10461
(718) 918-5446
(718) 918-6787
Mailing address
1400 PELHAM PARKWAY SOUTH, BUILDING 1 3 WEST 7, BRONX, NY 10461
(718) 918-5446
(718) 918-6787
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
F000783
NY
363LW0102X
Women's Health Nurse Practitioner
Primary
F420555
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02297698
—
NY
Enumeration date
10/29/2006
Last updated
12/15/2017
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