Individual
MRS. SUSANNE WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
424 N ALLEGHANY AVE, LINDENHURST, NY 11757-3437
(631) 891-5507
Mailing address
424 N ALLEGHANY AVE, LINDENHURST, NY 11757-3437
(631) 891-5507
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
469653
NY
Other
Enumeration date
05/25/2013
Last updated
05/25/2013
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