Provider Demographics
NPI:1023387628
Name:STRAIN, SUSAN M (RN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:M
Last Name:STRAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MERIDIAN DR.
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509
Mailing Address - Country:US
Mailing Address - Phone:845-279-3973
Mailing Address - Fax:
Practice Address - Street 1:30 FARM TO MARKET RD.
Practice Address - Street 2:BREWSTER CENTRAL SCHOOLS
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509
Practice Address - Country:US
Practice Address - Phone:845-279-5091
Practice Address - Fax:845-279-2808
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY249725390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program