Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Susan Fackelman

Individual provider Certified Registered Nurse Anesthetist · NPI 1437259777

Susan Fackelman is a Certified Registered Nurse Anesthetist (CRNA) in Mineola, New York. Qualified in 1988, 38 years ago. Practices with North Shore - Lij Anesthesiology, PC, a 1,004-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
38
Licensed in
NY
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

259 1st St
Mineola, NY 11501-3957
Phone: (516) 663-0333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 6675 (NY)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 407482 (NY)

Record details

NPI number1437259777
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 25, 2006
Last updated in NPPESJuly 14, 2020
Certification dateJuly 14, 2020
Mailing address216 1st St, Mineola, NY 11501-3901

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice North Shore - Lij Anesthesiology, Pc — 1004 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mineola