Provider Demographics
NPI:1942422282
Name:GJINI, SUSANNE T (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:T
Last Name:GJINI
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 1:26 GRANDVIEW TERRACE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1623
Mailing Address - Country:US
Mailing Address - Phone:201-825-8078
Mailing Address - Fax:
Practice Address - Street 1:26 GRANDVIEW TERRACE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1623
Practice Address - Country:US
Practice Address - Phone:201-825-8078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00517700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist