MEDICARE: SUSAN CHRISTINA NATOLI PT

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	225100000X	Physical Therapist	006743

General Provider Information

NPI Number	:	1588637797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CHRISTINA NATOLI PT

Provider Business Mailing Address
First Line	:	1160 MONTAUK HWY
Second Line	:
City	:	COPIAGUE
State	:	NY
Zip	:	11726
Country	:	US
Telephone Number	:	631-842-4606
Fax Number	:	631-842-0803

Provider Business Practice Location Address
First Line	:	1160 MONTAUK HWY
Second Line	:
City	:	COPIAGUE
State	:	NY
Zip	:	11726
Country	:	US
Telephone Number	:	631-842-4606
Fax Number	:	631-842-0803

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	06/28/2016

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Directions to “ SUSAN CHRISTINA NATOLI PT” Practice Location

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