MEDICARE: MS. SUSAN SOUTHERLAND SLP

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	235Z00000X	Speech-Language Pathologist	58 008901	NY

General Provider Information

NPI Number	:	1457633539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN SOUTHERLAND SLP

Provider Business Mailing Address
First Line	:	570 N PEARL ST
Second Line	:
City	:	MENANDS
State	:	NY
Zip	:	12204-1659
Country	:	US
Telephone Number	:	518-675-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	570 N PEARL ST
Second Line	:
City	:	MENANDS
State	:	NY
Zip	:	12204-1659
Country	:	US
Telephone Number	:	518-675-4800
Fax Number	:

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

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	09/14/2011

Similar Medicare Providers

1881978039 — MS. CAITLIN TAYLOR RN
Practice Location Address:

570 N PEARL ST , NORTH ALBANY ACADEMY
MENANDS, NY
12204-1659

Practice Phone: 518-475-6805
Practice Fax: 518-475-6802

1578848057 — DONNA M COONLEY LCSW
Practice Location Address:

570 N PEARL ST
MENANDS, NY
12204-1659

Practice Phone: 518-475-6808
Practice Fax:

1821534561 — LENORE PALLADINO RN
Practice Location Address:

570 N PEARL ST # M
MENANDS, NY
12204-1659

Practice Phone: 518-475-6805
Practice Fax: 518-475-6802

1083172910 — MICHELLE DILLON
Practice Location Address:

570 N PEARL ST
MENANDS, NY
12204-1659

Practice Phone: 518-475-6900
Practice Fax:

1992585236 — ACOLA MCKNIGHT
Practice Location Address:

570 N PEARL ST
MENANDS, NY
12204-1659

Practice Phone: 518-807-1458
Practice Fax:

1326829334 — WILLIAM EDWARD ROBERTS REGISTERED NURSE
Practice Location Address:

570 N PEARL ST
MENANDS, NY
12204-1659

Practice Phone: 518-475-6805
Practice Fax:

Directions to “ MS. SUSAN SOUTHERLAND SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.