Provider Demographics
NPI:1962674754
Name:HO, SUSANNA NGAFUN (OTR)
Entity type:Individual
Prefix:MS
First Name:SUSANNA
Middle Name:NGAFUN
Last Name:HO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:504 HAMBURG TPKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2034
Mailing Address - Country:US
Mailing Address - Phone:973-595-8899
Mailing Address - Fax:973-595-5855
Practice Address - Street 1:504 HAMBURG TPKE
Practice Address - Street 2:SUITE 205
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2034
Practice Address - Country:US
Practice Address - Phone:973-595-8899
Practice Address - Fax:973-595-5855
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00001200225XH1200X
NJ25MZ00021100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
457682Medicare PIN