| Doctor Name: | SUSAN MARIE TRAVIS |
| NPI Number: | 1104823863 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | F381651-1 |
| Business Practice Address: | 35 S Riverside Ave The Westchester Medical Practice Pc Croton On Hudson, NY - 105202653 |
| Business Phone Number: | 9142712424 |
| Business Fax Number: | 9142712172 |
| Mailing Address: | 50 Dayton Lane, Suite 202, The Westchester Medical Practice Pc PEEKSKILL |
| State: | NY |
| Postal Code: | 10566 |
| Phone Number: | 9147390087 |
| Fax Number: | 9147371714 |
| NPI Enumeration Date: | 07/07/2005 |
| NPI Last Update Date: | 08/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | F381651-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |