Provider Demographics
NPI:1316215957
Name:SUSCO, JANET MARIE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARIE
Last Name:SUSCO
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 1:129 STRINGHAM RD
Mailing Address - Street 2:#7
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5534
Mailing Address - Country:US
Mailing Address - Phone:845-471-4525
Mailing Address - Fax:
Practice Address - Street 1:167 MYERS CORNERS RD
Practice Address - Street 2:#200
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3869
Practice Address - Country:US
Practice Address - Phone:845-298-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-11
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003641-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist