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NPI Code Detail

MEDICARE: SUZANNE MARIE CSOP

MEDICARE: SUZANNE MARIE CSOP
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
1103TC0700XClinical PsychologistPS006218LPA
2163W00000XRegistered NurseRN281075LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
193943OTHERPACIGNA
2465230OTHERPAVALUEOPTIONS
3513061OTHERPAHIGHMARK KHPW
47756227OTHERPAAETNA
5796148OTHERPAHIGHMARK PAR W/ INDEMNITY

General Provider Information

NPI Number : 1841271871
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE MARIE CSOP
Provider Business Mailing Address
First Line : 1330 W 26TH ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1402
Country : US
Telephone Number : 814-459-9300
Fax Number : 814-451-2280
Provider Business Practice Location Address
First Line : 1330 W 26TH ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1402
Country : US
Telephone Number : 814-459-9300
Fax Number : 814-451-2280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 09/11/2025

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Directions to “ SUZANNE MARIE CSOP ” Practice Location

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