Provider Demographics
NPI:1164664256
Name:SANCHEZ, SUZANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SANCHEZ
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 1:170 E 4TH ST
Mailing Address - Street 2:APARTMENT 3H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1753
Mailing Address - Country:US
Mailing Address - Phone:917-676-8553
Mailing Address - Fax:
Practice Address - Street 1:170 E 4TH ST
Practice Address - Street 2:APARTMENT 3H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1753
Practice Address - Country:US
Practice Address - Phone:917-676-8553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007959174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist