Provider Demographics
NPI:1194992800
Name:SEMANSON, SUZANNE M (PT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:SEMANSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 BROADWAY
Mailing Address - Street 2:SUITE#510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1231
Mailing Address - Country:US
Mailing Address - Phone:212-253-9383
Mailing Address - Fax:212-253-5713
Practice Address - Street 1:873 BROADWAY
Practice Address - Street 2:SUITE#510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1231
Practice Address - Country:US
Practice Address - Phone:212-253-9383
Practice Address - Fax:212-253-5713
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029558-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist