Basic Information
| Provider Information | |||||||||
| NPI: | 1821327958 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHMAEL | ||||||||
| FirstName: | SUSAN | ||||||||
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| Credential: | A.P.R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | GRAY CANCER CTR | ||||||||
| Address2: | 85 RETREAT AVE | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602496291 | ||||||||
| FaxNumber: | 8607280151 | ||||||||
| Practice Location | |||||||||
| Address1: | GRAY CANCER CTR | ||||||||
| Address2: | 85 RETREAT AVE | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602496291 | ||||||||
| FaxNumber: | 8607280151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2009 | ||||||||
| LastUpdateDate: | 12/21/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 12.0004281 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.