Healthcare Provider Details

I. General information

NPI: 1205992427
Provider Name (Legal Business Name): SUSAN CALANTONI M.S., FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 OLD YORK RD SUITE 110B
ELKINS PARK PA
19027-1539
US

IV. Provider business mailing address

31 BELVIDERE ST
NAZARETH PA
18064-2104
US

V. Phone/Fax

Practice location:
  • Phone: 215-886-8660
  • Fax:
Mailing address:
  • Phone: 610-746-2178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT005906
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: