Provider Demographics
NPI:1528193463
Name:MCCAFFREY, SUSAN ANN (OTR)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 PENATIQUIT AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-3145
Mailing Address - Country:US
Mailing Address - Phone:516-804-3952
Mailing Address - Fax:
Practice Address - Street 1:2318 PENATIQUIT AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-3145
Practice Address - Country:US
Practice Address - Phone:516-804-3952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics