Provider Demographics
NPI:1790782647
Name:SUSPENSKI, THOMAS JOSEPH (PT, ATC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:SUSPENSKI
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:797 E LANCASTER AVE. SUITE 2
Mailing Address - Street 2:MIND & BODY FITNESS INC D.B.A. HEALTH CHECK INC
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335
Mailing Address - Country:US
Mailing Address - Phone:610-269-5070
Mailing Address - Fax:610-269-5074
Practice Address - Street 1:797 E LANCASTER AVE. SUITE 2
Practice Address - Street 2:MIND & BODY FITNESS INC D.B.A. HEALTH CHECK INC
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335
Practice Address - Country:US
Practice Address - Phone:610-269-5070
Practice Address - Fax:610-269-5074
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 001192E208100000X
PAPT001192E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2792903OtherAETNA
PA1356967OtherBC/BS - PERS. CHOICE
PA1356967OtherBC/BS - PERS. CHOICE