Provider Demographics
NPI:1497934020
Name:EBY, SUSAN C (PT MS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:EBY
Suffix:
Gender:F
Credentials:PT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:157 W 91ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1301
Mailing Address - Country:US
Mailing Address - Phone:917-971-7888
Mailing Address - Fax:347-699-1053
Practice Address - Street 1:157 W 91ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1301
Practice Address - Country:US
Practice Address - Phone:917-971-7888
Practice Address - Fax:347-699-1053
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013384-2225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist