MEDICARE: DR. SUSANNA CORDISH SATTEN DAC, L.AC., DIPL.AC.

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	171100000X	Acupuncturist	AK001186	PA

General Provider Information

NPI Number	:	1891146288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSANNA CORDISH SATTEN DAC, L.AC., DIPL.AC.

Provider Business Mailing Address
First Line	:	1305 MEDFORD RD
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-2418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 S 17TH ST STE 1502
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6215
Country	:	US
Telephone Number	:	215-469-1750
Fax Number	:

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

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	03/02/2017

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