MEDICARE: MS. SUZANA IRENE CLARK PTA

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	174400000X	Specialist	A2412	MD

General Provider Information

NPI Number	:	1932548757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUZANA IRENE CLARK PTA

Provider Business Mailing Address
First Line	:	100 ANTRIM BLVD
Second Line	:
City	:	TANEYTOWN
State	:	MD
Zip	:	21787-2277
Country	:	US
Telephone Number	:	410-756-6400
Fax Number	:	410-756-5173

Provider Business Practice Location Address
First Line	:	100 ANTRIM BLVD
Second Line	:
City	:	TANEYTOWN
State	:	MD
Zip	:	21787-2277
Country	:	US
Telephone Number	:	410-756-6400
Fax Number	:	410-756-5173

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

Provider Enumeration Date	:	06/15/2013
Last Update Date	:	06/15/2013

Similar Medicare Providers

1831190271 — LORIEN TANEYTOWN, INC
Practice Location Address:

100 ANTRIM BLVD
TANEYTOWN, MD
21787-2277

Practice Phone: 410-756-5884
Practice Fax: 410-756-5894

1861838849 — MELANIE CAITLIN SCHERER M.S. CCC SLP
Practice Location Address:

100 ANTRIM BLVD
TANEYTOWN, MD
21787-2277

Practice Phone: 888-479-1161
Practice Fax:

1144668773 — KRISTEL CASTONGUAY PT
Practice Location Address:

100 ANTRIM BLVD
TANEYTOWN, MD
21787-2277

Practice Phone: 410-756-6400
Practice Fax:

1316892383 — MRS. SARA JANE FANKHAUSER
Practice Location Address:

123 DIVERN ST
TANEYTOWN, MD
21787-2246

Practice Phone: 240-215-7372
Practice Fax:

1851194765 — BRIDGINGLIFE, INC
Practice Location Address:

3217 BERT KOONTZ RD
TANEYTOWN, MD
21787-1603

Practice Phone: 410-871-8000
Practice Fax:

1336942101 — BRIDGINGLIFE, INC
Practice Location Address:

100 ANTRIM BLVD
TANEYTOWN, MD
21787-2288

Practice Phone: 410-871-8000
Practice Fax:

Directions to “ MS. SUZANA IRENE CLARK PTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.