Provider Demographics
NPI:1962861971
Name:NAVILIO, SUSAN (LPN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:NAVILIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 ROUTE 72 W
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2489
Mailing Address - Country:US
Mailing Address - Phone:609-350-2524
Mailing Address - Fax:609-978-5550
Practice Address - Street 1:1322 ROUTE 72 W
Practice Address - Street 2:SUITE 204
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2489
Practice Address - Country:US
Practice Address - Phone:609-350-2524
Practice Address - Fax:609-978-5550
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP0366N600164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse