Provider Demographics
NPI:1790240059
Name:DINNOCENTI, SUSAN T (NBC-HWC, DPP)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:T
Last Name:DINNOCENTI
Suffix:
Gender:F
Credentials:NBC-HWC, DPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6647
Mailing Address - Country:US
Mailing Address - Phone:203-536-5496
Mailing Address - Fax:
Practice Address - Street 1:1304 VALLEY DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-6647
Practice Address - Country:US
Practice Address - Phone:203-536-5496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator