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General NPI Number Information
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NPI Number | 1477853067
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Entity Type | Individual
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Provider Name | SUZANNE MARIE SCARZAFAVA P.T.A.
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Gender | Female
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 156 ROUTE 302
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City | PINE BUSH
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State | NY
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Zip | 12566
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Country | US
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Telephone | 845-744-2031
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 155 4 BRUSH ROAD
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City | SUMMITVILLE
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State | NY
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Zip | 12781
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Country | US
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Telephone | 845-888-4276
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 000619-1
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License Number State | NY
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