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General NPI Number Information
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NPI Number | 1598917841
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Entity Type | Individual
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Provider Name | SUSAN RONAN P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 600 BEAR RIDGE RD
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City | PLEASANTVILLE
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State | NY
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Zip | 10570-2543
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Country | US
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Telephone | 917-902-8781
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Fax |
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Provider Business Mailing Address
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Address Line | 39 CRADLE ROCK RD
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City | POUND RIDGE
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State | NY
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Zip | 10576-2210
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Country | US
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Telephone | 917-902-8781
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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 | 010993-1
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License Number State | NY
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