Susan Bernadette Shively, RN
Registered Nurse in Cicero, NY. Individual provider (NPI-1).
NPI number1609200443
StatusActive
Last updated in NPPESAug 28, 2013
Details
- NPI
- 1609200443
- Entity type
- Individual (NPI-1)
- Name
- Susan Bernadette Shively
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 28, 2013
- Last updated
- Aug 28, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 441201-1 | NY | Yes |
Practice location
7420 Mapleview RdCicero, NY 13039-9726
Phone 315-399-9161
Mailing address
7420 Mapleview RdCicero, NY 13039-9726
Phone 315-399-9161
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 14 Registered Nurse providers in Cicero · All 330 providers in Cicero
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