SUSAN L COLLEMER (NPI# 1174570865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174570865 |
| Entity Type | Individual |
| Full Name | SUSAN L COLLEMER |
| Credential | M.D. |
| Practice Address |
326 Washington St Norwich CT 06360-2740 |
| Practice Telephone | 8608898331 |
| Mailing Telephone | 8608898331 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2018-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 55273 | CT | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 224252 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2215 Burdett Ave, Troy, NY 121802466 | 5182713450 |
| Street Address |
326 WASHINGTON ST |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992076 | Lisa Ann White | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2005-06-15 |
| 1942818380 | Janankia Andrea Thomas | Counselor | 326 Washington St, Norwich, CT 06360-2740 | 2020-07-22 |
| 1306467170 | Hannah Perna | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2020-05-02 |
| 1851920540 | Nicole Patricia Golden | Registered Nurse | 326 Washington St, Norwich, CT 06360-2740 | 2020-04-04 |
| 1154955854 | Brynne E Radel | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2020-03-03 |
| 1801359955 | James Dreier | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2019-04-07 |
| 1346715349 | Aldo Mauricio Velasquez | Physician Assistant | 326 Washington St, Norwich, CT 06360 | 2018-10-05 |
| 1073092557 | Devin Stanton | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-08-07 |
| 1699260737 | Kevin Connolly | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-06-29 |
| 1275034456 | Lori A Desbonnet | Social Worker | 326 Washington St, Norwich, CT 06360-2740 | 2018-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588761118 | Stanley J Czarnecki | Emergency Medicine | 179 North Broad Strreet, Norwich, NY 13815-1019 | 2006-09-17 |
| 1609230531 | James Robert Engel | Emergency Medicine | 326 Washington St, Norwich, CT 06360 | 2016-04-06 |
| 1952797516 | Matthew Macaskill | Emergency Medicine | 326 Washington St, Norwich, CT 06360-2740 | 2015-04-10 |
| 1659669059 | Robert E. Creutz Sr. | Emergency Medicine | 111 Salem Tpke, Norwich, CT 06360-7403 | 2011-07-19 |
| 1770743643 | Lindsay Sloane Roberts | Emergency Medicine | 326 Washington St, Emergency Department, Norwich, CT 06360-2740 | 2008-06-13 |
| 1033380985 | W. Gordon Van Nes | Emergency Medicine | 326 Washington St, Norwich, CT 06360-2740 | 2008-03-19 |
| 1326167768 | William Boudreau | Emergency Medicine | 179 N Broad St, Norwich, NY 13815-1019 | 2007-03-28 |
| 1306925292 | Richard G Ryan | Emergency Medicine | 326 Washington St, Norwich, CT 06360 | 2006-11-03 |
| 1821179722 | Yusuf Harper | Emergency Medicine | 179 N Broad St, Norwich, NY 13815-1019 | 2006-10-18 |
| 1952496440 | Richard Goulding | Emergency Medicine | 326 Washington St, Backus Hospital, Department of Emergency Medicine, Norwich, CT 06360-2740 | 2006-10-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.