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General NPI Number Information
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NPI Number | 1588793772
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Entity Type | Individual
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Provider Name | SUSAN ENZER MS
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 450 VETERANS MEMORIAL PKWY # 1
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-5300
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Country | US
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Telephone | 401-435-5644
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Fax |
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Provider Business Mailing Address
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Address Line | 11 OLD CHIMNEY RD
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City | BARRINGTON
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State | RI
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Zip | 02806-3224
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Country | US
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Telephone | 401-247-1954
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD00075
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License Number State | RI
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