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General NPI Number Information
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NPI Number | 1376495440
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Entity Type | Individual
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Provider Name | AMANDA SUSSMAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1135 BROAD ST
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City | CLIFTON
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State | NJ
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Zip | 07013-3346
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Country | US
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Telephone | 973-574-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 80 LENOX RD
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City | WAYNE
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State | NJ
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Zip | 07470-5551
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Country | US
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Telephone | 551-204-0913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 40QA02399700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 40QA02399700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA02399700
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License Number State | NJ
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