| Doctor Name: | SUSAN L. BATES |
| NPI Number: | 1255442869 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CDE |
| License Number: | 427188 |
| Business Practice Address: | 112 Charlton Road Ballston Lake, NY - 120192547 |
| Business Phone Number: | 5183997723 |
| Business Fax Number: | 5183997753 |
| Mailing Address: | 112 Charlton Road, BALLSTON LAKE |
| State: | NY |
| Postal Code: | 120192547 |
| Phone Number: | 5183997723 |
| Fax Number: | 5183997753 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 04/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 427188 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |