Mini Susan Mammen, - Medicare Nurse Practitioner in Great Neck, NY

Mini Susan Mammen, is a medicare enrolled "Nurse Practitioner - Family" in Great Neck, New York. Her current practice location is 310 E Shore Rd, Great Neck, New York. You can reach out to her office (for appointments etc.) via phone at (516) 482-8657.

Mini Susan Mammen is licensed to practice in New York (license number F344251) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780241398.

Contact Information

Mini Susan Mammen,
310 E Shore Rd,
Great Neck, NY 11023-2410
(516) 482-8657
Not Available



Provider's Profile

Full NameMini Susan Mammen
GenderFemale
SpecialityNurse Practitioner - Family
Location310 E Shore Rd, Great Neck, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1780241398
  • Provider Enumeration Date: 05/20/2019
  • Last Update Date: 11/11/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 0446658033
  • Enrollment ID: I20211012003230

Medical Identifiers

Medical identifiers for Mini Susan Mammen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780241398NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SF0001XClinical Nurse Specialist - Family Health F344251 (New York)Secondary
363LF0000XNurse Practitioner - Family F344251 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mini Susan Mammen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mini Susan Mammen,
475 Beech St,
New Hyde Park, NY 11040-3825

Ph: (718) 598-0529
Mini Susan Mammen,
310 E Shore Rd,
Great Neck, NY 11023-2410

Ph: (516) 482-8657

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› Verified 3 days ago


Nurse Practitioner Nurses in Great Neck, NY

Cindy Queliza,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 805 Northern Blvd, Great Neck, NY 11021
Phone: 516-614-1160    
Sarah Haseney, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 865 Northern Blvd, Great Neck, NY 11021
Phone: 516-622-5155    
Blayne Manning,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 225 Community Dr, #110, Great Neck, NY 11021
Phone: 516-918-4388    
Yuna Zyskind, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 51 Great Neck Rd, Great Neck, NY 11021
Phone: 516-829-4100    
Grace Couch, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 865 Northern Blvd, Great Neck, NY 11021
Phone: 516-622-5114    
Elissa Michelle Martin, ANP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 310 E Shore Rd Ste 104, Great Neck, NY 11023
Phone: 516-829-9550    
Chantal Ganci, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 611 Northern Blvd, Great Neck, NY 11021
Phone: 516-723-2663    

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