Provider Demographics
NPI:1376690974
Name:MCBRIDE, SUSAN CECELIA (DPT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CECELIA
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:227 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-3523
Mailing Address - Country:US
Mailing Address - Phone:518-243-4684
Mailing Address - Fax:518-243-4342
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:MEDICAL ARTS BUILDING SUITE 302
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-243-4684
Practice Address - Fax:518-243-4342
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0287321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist