Provider Demographics
NPI:1598248460
Name:CASALES, SUSANA (PTA)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:CASALES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8993
Mailing Address - Country:US
Mailing Address - Phone:845-541-9555
Mailing Address - Fax:
Practice Address - Street 1:3 NEPTUNE RD STE A19B
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5569
Practice Address - Country:US
Practice Address - Phone:914-816-8969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant