Provider Demographics
NPI:1891457461
Name:SMOLINSKY, SUZANNE (LMT, LE, EMT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SMOLINSKY
Suffix:
Gender:F
Credentials:LMT, LE, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 ORANGE CENTER RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2400
Mailing Address - Country:US
Mailing Address - Phone:475-731-8279
Mailing Address - Fax:
Practice Address - Street 1:663 ORANGE CENTER RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2400
Practice Address - Country:US
Practice Address - Phone:475-731-8279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12053146N00000X
MA16731225700000X
CT10423225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic