Provider Demographics
NPI:1346551470
Name:ALLEN, SUZANNE MARY (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MARY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 ARMORY DR
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5405
Mailing Address - Country:US
Mailing Address - Phone:315-798-4006
Mailing Address - Fax:315-798-4004
Practice Address - Street 1:1601 ARMORY DR
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5405
Practice Address - Country:US
Practice Address - Phone:315-798-4006
Practice Address - Fax:315-798-4004
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000273-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist