MEDICARE: MRS. SUSAN PILSON SCHREINER LMFT, CASAC

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	106H00000X	Marriage & Family Therapist	000089	NY

General Provider Information

NPI Number	:	1265580336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN PILSON SCHREINER LMFT, CASAC

Provider Business Mailing Address
First Line	:	1210 MCFADDEN DR
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-2722
Country	:	US
Telephone Number	:	631-757-1593
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 MCFADDEN DR
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-2722
Country	:	US
Telephone Number	:	631-757-1593
Fax Number	:

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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