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SUSAN M BORDONARO
51 LONG WHARF MALL NEWPORT RI 28402906
SUSAN M BORDONARO is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1366547358. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 648211466. The primary specialty is NURSE PRACTITIONER. The organization is ASPIRE DERMATOLOGY LLC. The address is 51 LONG WHARF MALL, , NEWPORT, RI, 28402906. The zip code is 28402906.
|Nation Provider ID||1366547358|
|PAC ID by PECOS||648211466|
|Professional Enrollment ID||I20050520000924|
|Name||SUSAN M BORDONARO|
|Medical School Name||OTHER|
|Primary Specialty||NURSE PRACTITIONER|
|All secondary specialties|
|Organization Name||ASPIRE DERMATOLOGY LLC|
|Group Practice PAC ID||1759550643|
|Number of Group Practice members||2|
|Address||51 LONG WHARF MALL, , NEWPORT, RI, 28402906|
|Hospital affiliation LBN||NEWPORT HOSPITAL|