Provider Demographics
NPI:1699961748
Name:MCCANN, SUZANNE EINSMANN
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:EINSMANN
Last Name:MCCANN
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 1:401 GORDON DR STE A
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1276
Mailing Address - Country:US
Mailing Address - Phone:610-280-0182
Mailing Address - Fax:
Practice Address - Street 1:401 GORDON DR STE A
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1276
Practice Address - Country:US
Practice Address - Phone:610-280-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-22
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010384225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics