Provider Demographics
NPI:1285701847
Name:STILL, SUSAN L (PT)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:L
Last Name:STILL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:SMALLSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3445 POST ROAD
Mailing Address - Street 2:J. ARTHUR TRUDEAU MEMORIAL CENTER
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7147
Mailing Address - Country:US
Mailing Address - Phone:401-739-2700
Mailing Address - Fax:401-737-8907
Practice Address - Street 1:3445 POST ROAD
Practice Address - Street 2:J. ARTHUR TRUDEAU MEMORIAL CENTER
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7147
Practice Address - Country:US
Practice Address - Phone:401-739-2700
Practice Address - Fax:401-737-8907
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKC02260Medicaid
RI408253OtherBLUE CHIP
RI4224OtherNEIGHBORHOOD HEALTH
RI6400187OtherUNITED HEALTHCARE
RI233086OtherBC BS