Provider Demographics
NPI:1043511637
Name:ROBERTS, SUSAN LLOYD (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LLOYD
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2309
Mailing Address - Country:US
Mailing Address - Phone:718-517-0807
Mailing Address - Fax:718-886-0291
Practice Address - Street 1:3527 UTOPIA PKWY
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2309
Practice Address - Country:US
Practice Address - Phone:718-517-0807
Practice Address - Fax:718-886-0291
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3437225XF0002X, 225XH1300X, 225XP0200X, 225XR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
No225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community Mobility