Individual
SUSAN LEE MOENCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.,M.S.,C.S.,N.P.
Contact information
Practice address
35 STATE ST, TULLY, NY 13159-3218
(315) 696-0264
(315) 696-0264
Mailing address
35 STATE ST, TULLY, NY 13159-3218
(315) 696-0264
(315) 696-0264
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
312927-1
NY
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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