Provider Demographics
NPI:1821231416
Name:PICURRO, SUZANNE LOUISE (PT)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:LOUISE
Last Name:PICURRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:SEAL COVE
Mailing Address - State:ME
Mailing Address - Zip Code:04674-0370
Mailing Address - Country:US
Mailing Address - Phone:207-244-4311
Mailing Address - Fax:
Practice Address - Street 1:131 EDEN ST
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1137
Practice Address - Country:US
Practice Address - Phone:207-288-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-12
Last Update Date:2009-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist