Provider Demographics
NPI:1962691816
Name:FENYES, SUSAN B (BS MA)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:B
Last Name:FENYES
Suffix:
Gender:F
Credentials:BS MA
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:B
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSMA
Mailing Address - Street 1:204 EDGEMONT PL
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4619
Mailing Address - Country:US
Mailing Address - Phone:201-801-0731
Mailing Address - Fax:
Practice Address - Street 1:204 EDGEMONT PL
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4619
Practice Address - Country:US
Practice Address - Phone:201-801-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00657800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist