Individual
SUSAN JEAN LENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5990 ROUTE 28, PHOENICIA, NY 12464
(845) 688-5779
Mailing address
PO BOX 645, PHOENICIA, NY 12464-0645
(845) 688-5779
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
510996
NY
163WH0200X
Home Health Registered Nurse
Primary
510996
NY
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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