Individual provider · Type 1 NPI

Susan Phelan, PH D NP

Nurse Practitioner · Port Jefferson, NY

NPI number 1487711636 Active

Practice location

251 E Oakland Ave Ste 2A
Port Jefferson, NY 11777-2602

Call (631) 760-1830 Map

Fax (631) 509-6080

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XF4001481 (NY)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1487711636

Susan Phelan, PH D NP's National Provider Identifier is 1487711636, issued on Jan 3, 2007. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Port Jefferson, NY. The record was last updated on Feb 16, 2026.