Healthcare Provider Details

I. General information

NPI: 1609950351
Provider Name (Legal Business Name): SUSAN LEIGH SZOT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 EXCHANGE ST
MALDEN MA
02148-5514
US

IV. Provider business mailing address

15 LIBBEE RD
CANDIA NH
03034-2312
US

V. Phone/Fax

Practice location:
  • Phone: 781-397-6945
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3133
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF306480-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: