Individual
MS. SUSANNA CLARE FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPWH
Contact information
Practice address
21 GRAND ST, KINGSTON, NY 12401-3933
(845) 562-7800
Mailing address
190 HUGUENOT ST, NEW PALTZ, NY 12561-1018
(845) 399-0245
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F421630-01
NY
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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