Susan Ingram
Susan Ingram is a Nurse Practitioner in Stony Brook, New York. Qualified in 2022, 4 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment. Licensed in New York.
- Years since qualifying
- 4
- Licensed in
- NY
- In the registry since
- 2015
- Specialties on file
- 2
Practice location Address checks out
101 Nicolls RdStony Brook, NY 11794-1651
Phone: (631) 638-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Health Nurse Practitioner (primary) | Taxonomy 363LA2200X · Licence 310911 (NY) |
|---|---|
| Psychiatric/Mental Health Registered Nurse | Taxonomy 163WP0808X · Licence 704126-1 (NY) |
Record details
| NPI number | 1952779878 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 9, 2015 |
| Last updated in NPPES | September 23, 2022 |
| Certification date | September 23, 2022 |
| Mailing address | 39 Clarendon St, Dix Hills, NY 11746-6933 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Group practice | Stony Brook Internists University Faculty Practice Corporation — 428 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Stony Brook
-
MS. Lisa Ann Digregorio, NP-PSYCHIATRY
Putnam Hall, Stony Brook, NY 11790 · (631) 632-9510
-
Nicole A Sandberg, MSN-PMHNP
101 Nicolls Rd, Stony Brook, NY 11794-0001 · (631) 638-1575
-
Vincent Verzino, RN
101 Nicolls Rd, Stony Brook, NY 11794-0001 · (631) 444-6050
-
Mr. Brian Thomas Wood, PMHNP-BC
169 Putnam Hall, Stony Brook, NY 11794-8790 · (631) 632-2428