Provider Demographics
NPI:1124534813
Name:EHINGER, SUZANNE GARRISON (MS, LCAT, BC-DMT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:GARRISON
Last Name:EHINGER
Suffix:
Gender:F
Credentials:MS, LCAT, BC-DMT
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LCAT, BC-DMT
Mailing Address - Street 1:441 16TH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5892
Mailing Address - Country:US
Mailing Address - Phone:917-530-5353
Mailing Address - Fax:
Practice Address - Street 1:36 PLAZA ST E STE 1G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5039
Practice Address - Country:US
Practice Address - Phone:917-765-2830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001767-1225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist