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NPI Code Detail

MEDICARE: SUSAN M PERNICE OTR/L

MEDICARE: SUSAN M PERNICE OTR/L
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
1225X00000XOccupational Therapist016017-1NY
2225XP0200XPediatric Occupational Therapist016017-1NY

General Provider Information

NPI Number : 1144541236
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M PERNICE OTR/L
Provider Business Mailing Address
First Line : 60 MONITOR ST
Second Line : APT 5B
City : BROOKLYN
State : NY
Zip : 11222-5107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 138 READE ST
Second Line :
City : NEW YORK
State : NY
Zip : 10013-3968
Country : US
Telephone Number : 212-608-9661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2010
Last Update Date : 06/12/2010

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Directions to “ SUSAN M PERNICE OTR/L” Practice Location

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