Provider Demographics
NPI:1093052474
Name:LEVINSON, SUSAN B (MSPT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:B
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9709
Mailing Address - Country:US
Mailing Address - Phone:302-547-8882
Mailing Address - Fax:
Practice Address - Street 1:1704 ROSEWOOD LN
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9709
Practice Address - Country:US
Practice Address - Phone:302-547-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0000931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist