Provider Demographics
NPI:1114530094
Name:ESPEUT, SUZETTE (MA, CCC)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:
Last Name:ESPEUT
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W 173RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1107
Mailing Address - Country:US
Mailing Address - Phone:516-591-0553
Mailing Address - Fax:
Practice Address - Street 1:360 E 168TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3706
Practice Address - Country:US
Practice Address - Phone:646-596-1331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030025235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist