DR. SUSAN NISSEN (NPI# 1518015650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518015650 |
| Entity Type | Individual |
| Full Name | DR. SUSAN NISSEN |
| Credential | PH.D. |
| Practice Address |
25 Wiltshire Dr Commack NY 11725-3330 |
| Practice Telephone | 5165214148 |
| Mailing Telephone | 5165214148 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
010793-1 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306870225 | Susan J Nissen | Physical Medicine & Rehabilitation | 924 1st St Ne, Faribault, MN 55021-5441 | 2006-07-10 |
| Street Address |
25 WILTSHIRE DR |
| City | COMMACK |
| State | NY |
| Zip Code | 11725-3330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699322131 | Amanda Grace Acebedo | Student in an Organized Health Care Education/Training Program | 785 Larkfield Rd, Commack, NY 11725 | 2019-08-20 |
| 1922667716 | Diana Mcnamara | Social Worker | 13 Audrey Lane, Commack, NY 11725 | 2019-06-06 |
| 1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
| 1437661501 | Commack Chemist Inc | Pharmacy | 6216 Jericho Turnpike, Commack, NY 11725 | 2017-10-30 |
| 1285168880 | Stephanie Arico | Counselor | 14 Silver Pond Cir, Commack, NY 11725 | 2017-04-20 |
| 1235684432 | Ams Primary Medical Care House Calls,pc | Home Health | 6277 Jericho Tpk, Commack, NY 11725 | 2016-08-18 |
| 1376927459 | Min Sun Park | Dentist | All About Smiles Pediatric Dentistry, 5036 Jericho Turnpike Suite #307, Commack, NY 11725 | 2015-07-17 |
| 1467843748 | Joanna Keegan | Pharmacy Technician | 98 Veterans Memorial Highway, Commack, NY 11725 | 2015-02-09 |
| 1275936841 | Jennie Bernstein | Social Worker | 368 Veterans Hwy Ste 2, Commack, NY 11725 | 2014-09-26 |
| 1417362021 | Diana Matira Yildirim | Pediatrics | 646 Commack Road, Commack, NY 11725 | 2014-06-23 |
| Find all providers in zip 11725 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780933408 | Shana Kabert | Psychologist | 6 Trumpet Ln, Commack, NY 11725-2725 | 2012-09-10 |
| 1770842254 | Danielle Paige Bissett | Psychologist | 356 Veterans Hwy Ste 2, Commack, NY 11725-4332 | 2012-05-03 |
| 1639396161 | Zamir Korn | Psychologist | 631 Commack Rd, Commack, NY 11725-5400 | 2007-04-19 |
| 1346314457 | Valerie Elise Silverberg | Psychologist | 356 Veteran Hwy, Commack, NY 11725 | 2006-11-20 |
| 1184706715 | Daniel Boyle | Psychologist | 5036 Jericho Tpke, Suite 203, Commack, NY 11725-2812 | 2006-10-20 |
| 1043238785 | Christine Marra | Psychologist | 358 Veterans Memorial Hwy Ste 9, Commack, NY 11725-4326 | 2006-07-18 |
| 1588698070 | Stephen Michael Guido | Psychologist | 35 Crooked Hill Rd, Suite 203-e, Commack, NY 11725-5415 | 2006-07-10 |
| 1649208752 | Stephen Lloyd Kaplan | Psychologist | 35 Crooked Hill Rd Ste 102, Commack, NY 11725-5415 | 2006-06-29 |
| 1760437255 | Sharon C. Leon | Psychologist | 145 Commack Rd, Suite 13, Commack, NY 11725 | 2006-05-23 |
| 1407851686 | Alan David Kaplan | Psychologist | 40 Annandale Dr, Commack, NY 11725-1745 | 2005-06-15 |
| Find all providers in COMMACK | ||||
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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.