| Doctor Name: | MS. SUSAN S MACKNAIR |
| NPI Number: | 1003846122 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | F420016-1 |
| Business Practice Address: | 62 Hackett Blvd Albany, NY - 122091756 |
| Business Phone Number: | 5184653318 |
| Business Fax Number: | 5182727458 |
| Mailing Address: | 62 Hackett Blvd, ALBANY |
| State: | NY |
| Postal Code: | 122091756 |
| Phone Number: | 5184653318 |
| Fax Number: | 5182727458 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 04/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LX0001X |
| License Number: | F420016-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Obstetrics & Gynecology |
| Taxonomy Definition: | |