Provider Demographics
NPI:1891070801
Name:FRANCO, SUSANNA (MS- CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNA
Middle Name:
Last Name:FRANCO
Suffix:
Gender:F
Credentials:MS- CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 MAMARONECK AVE
Mailing Address - Street 2:MAMARONECK AVENUE SCHOOL
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10523
Mailing Address - Country:US
Mailing Address - Phone:914-220-3600
Mailing Address - Fax:
Practice Address - Street 1:850 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10523
Practice Address - Country:US
Practice Address - Phone:914-220-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013839235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01395326Medicaid