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NPI Code Detail

MEDICARE: MRS. SUZANNE SMITH BRANDLEY MS, OTR/L, CHT

MEDICARE: MRS. SUZANNE SMITH BRANDLEY MS, OTR/L, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOC006788-LPA
2225XH1200XHand Occupational Therapist1051100607PA

General Provider Information

NPI Number : 1093774200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZANNE SMITH BRANDLEY MS, OTR/L, CHT
Provider Business Mailing Address
First Line : 11 VICTORIA DRIVE
Second Line :
City : WOOLWICH
State : NJ
Zip : 08085
Country : US
Telephone Number : 215-378-1856
Fax Number :
Provider Business Practice Location Address
First Line : 511 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-3230
Country : US
Telephone Number : 215-923-6031
Fax Number : 215-923-8269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 03/26/2014

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