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Individual

MS. SUSAN C. PEDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
327 ROUTE 59, AIRMONT, NY 10952
(845) 356-2900
Mailing address
507 AIRPORT EXECUTIVE PARK, NANUET, NY 10954-5238
(845) 262-5313
(845) 262-5330

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
321489
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
P33251
NY
Enumeration date
10/05/2005
Last updated
12/17/2018
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