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Individual

SUSAN J LINEHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5415 W GENESEE ST, SUITE 301, CAMILLUS, NY 13031-2162
(315) 487-8109
(315) 487-5680
Mailing address
5415 W GENESEE ST, SUITE 301, CAMILLUS, NY 13031-2162
(315) 487-8109
(315) 487-5680

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F000479
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01791111
NY
Enumeration date
01/25/2006
Last updated
08/17/2007
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