Ivander Susanto, BSN, RN, MSN, FNP
Registered Nurse in Hasbrouck Heights, NJ. Individual provider (NPI-1).
NPI number1932007341
StatusActive
Last updated in NPPESOct 27, 2026
Details
- NPI
- 1932007341
- Entity type
- Individual (NPI-1)
- Name
- Ivander Susanto
- Credential
- BSN, RN, MSN, FNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 27, 2026
- Certification date
- Oct 27, 2026
- Last updated
- Oct 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 26NR21950300 | NJ | Yes |
| 163W00000X | Registered Nurse | 804783 | NY |
Practice location
128 Burr PlHasbrouck Heights, NJ 07604-2525
Phone 201-755-4018
Mailing address
128 Burr PlHasbrouck Heights, NJ 07604-2525
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