MEDICARE: SUSAN M CAREY R.EEGT., RPSGT.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0500X	EEG Specialist/Technologist

General Provider Information

NPI Number	:	1033414065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN M CAREY R.EEGT., RPSGT.

Provider Business Mailing Address
First Line	:	295 N BISHOP AVE
Second Line	:
City	:	CLIFTON HEIGHTS
State	:	PA
Zip	:	19018-1129
Country	:	US
Telephone Number	:	484-432-4005
Fax Number	:	610-626-2185

Provider Business Practice Location Address
First Line	:	295 N BISHOP AVE
Second Line	:
City	:	CLIFTON HEIGHTS
State	:	PA
Zip	:	19018-1129
Country	:	US
Telephone Number	:	484-432-4005
Fax Number	:	610-626-2185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2011
Last Update Date	:	01/23/2011

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