MEDICARE: DR. SUSAN LOBERFELD PT, DPT

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
1	225100000X	Physical Therapist	026737	NY

General Provider Information

NPI Number	:	1518046309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN LOBERFELD PT, DPT

Provider Business Mailing Address
First Line	:	3755 HENRY HUDSON PKWY APT 8C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1538
Country	:	US
Telephone Number	:	347-347-3132
Fax Number	:	347-438-2942

Provider Business Practice Location Address
First Line	:	3801 N 40TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-1860
Country	:	US
Telephone Number	:	347-347-3132
Fax Number	:	347-438-2942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/21/2022

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