1801846308 NPI number — MRS. SUSAN ORNSTEIN-NONNON

Table of content: MRS. SUSAN ORNSTEIN-NONNON (NPI 1801846308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801846308 NPI number — MRS. SUSAN ORNSTEIN-NONNON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORNSTEIN-NONNON
Provider First Name:
SUSAN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ORNSTEIN
Provider Other First Name:
SUSAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS RD CDN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1801846308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3824 213TH ST
Provider Second Line Business Mailing Address:
SUITE 3G
Provider Business Mailing Address City Name:
BAYSIDE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11361-2072
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-423-7825
Provider Business Mailing Address Fax Number:
718-423-7825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3824 213TH ST
Provider Second Line Business Practice Location Address:
SUITE 3G
Provider Business Practice Location Address City Name:
BAYSIDE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11361-2072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-423-7825
Provider Business Practice Location Address Fax Number:
718-423-7825
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 724768 . This is a "COMMISSION OR DIETETIC OR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000971 . This is a "THE STATE EDUCATOR DEPT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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