Provider Demographics
NPI:1104056464
Name:GROPPE, SUSAN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:GROPPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 ROUNDTOP RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2328
Mailing Address - Country:US
Mailing Address - Phone:914-282-2256
Mailing Address - Fax:
Practice Address - Street 1:3718-3726 HENRY HUDSON PKWY
Practice Address - Street 2:SUITE 1005
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1500
Practice Address - Country:US
Practice Address - Phone:718-432-1618
Practice Address - Fax:631-467-0928
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000870-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist