Provider Demographics
NPI:1083935308
Name:REIN, SUSAN LEE (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEE
Last Name:REIN
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 E 68TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6001
Mailing Address - Country:US
Mailing Address - Phone:212-737-8946
Mailing Address - Fax:212-737-5214
Practice Address - Street 1:246 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6001
Practice Address - Country:US
Practice Address - Phone:212-737-8946
Practice Address - Fax:212-737-5214
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000717-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist