Individual provider · Type 1 NPI
Mini Susan Mammen
Family Nurse Practitioner · Great Neck, NY
NPI number
1780241398
Active
Practice location
310 E Shore Rd
Great Neck, NY 11023-2410
Mailing address
475 Beech St
New Hyde Park, NY 11040-3825
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | F344251 (NY) |
| Family Nurse Practitioner Primary | 363LF0000X | F344251 (NY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1780241398
Mini Susan Mammen's National Provider Identifier is 1780241398, issued on May 20, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Great Neck, NY. The record was last updated on Nov 11, 2019.