Provider Demographics
NPI:1558469205
Name:VARUSO, SUSAN S (OT,CHT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:S
Last Name:VARUSO
Suffix:
Gender:F
Credentials:OT,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 NAPOLEON AVE
Mailing Address - Street 2:SUITE 615
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6357
Mailing Address - Country:US
Mailing Address - Phone:504-895-0638
Mailing Address - Fax:504-891-5676
Practice Address - Street 1:5008 W ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2551
Practice Address - Country:US
Practice Address - Phone:504-885-9675
Practice Address - Fax:504-885-9664
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10704174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C404C460Medicare ID - Type UnspecifiedPROVIDER ID