Provider Demographics
NPI:1457650806
Name:KUZMIK, SUSAN D
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:D
Last Name:KUZMIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 VIOLA RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3228
Mailing Address - Country:US
Mailing Address - Phone:845-357-3800
Mailing Address - Fax:
Practice Address - Street 1:49 VIOLA RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-3228
Practice Address - Country:US
Practice Address - Phone:845-357-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001802-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist