Provider Demographics
NPI:1932302452
Name:CASSONE, SUSAN L (RPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:CASSONE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 DUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6232
Mailing Address - Country:US
Mailing Address - Phone:603-580-5471
Mailing Address - Fax:
Practice Address - Street 1:442 MAIN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NH
Practice Address - Zip Code:03044-3434
Practice Address - Country:US
Practice Address - Phone:603-895-3126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist