Individual
SUSAN LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
74 SCHOOL DR, CENTRAL SQUARE, NY 13036-3501
(315) 668-4281
(315) 668-4356
Mailing address
74 SCHOOL DR, CENTRAL SQUARE, NY 13036-3501
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
2703601
NY
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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