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Susan M Randall-mantella, RNNP
Family Nurse Practitioner in Fayetteville, New York
NPI 1457314650

Susan M Randall-mantella is a Family Nurse Practitioner based in Fayetteville, NY and is specialized in Family. Susan M Randall-mantella practices in Fayetteville, NY and has the professional credentials of RNNP. The NPI Number for Susan M Randall-mantella is 1457314650 and holds a License No. F330714 (New York).

The current practice location address for Susan M Randall-mantella is 4117 Medical Center Dr, Fayetteville, NY and can be reached out via phone at 315-329-4975 and via fax at 315-329-4970.

Location: 4117 Medical Center Dr, Fayetteville, NY, 13066-6600
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Provider Profile Details
NPI Number
1457314650
Provider Name
Susan M Randall-mantella
Credential
RNNP
Provider Entity Type
Individual
Gender
Female
Address
4117 Medical Center Dr, Fayetteville, NY, 13066-6600
Phone Number
315-329-4975
Fax Number
315-329-4970
Provider Enumeration Date
04/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02245370 05 NY
institution
Provider Business Practice Location Address Details
Address
4117 Medical Center Dr
City
State
Zip
13066-6600
Phone Number
315-329-4975
Fax Number
315-329-4970
person
Provider Business Mailing Address Details
Address
4117 Medical Center Dr
City
State
Zip
13066-6600
Phone Number
315-329-4975
Fax Number
315-329-4970
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
F330714 (New York)
Definition
Definition to come...
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