Provider Demographics
NPI:1205806270
Name:FLEESON-DASILVA, SUZANNE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:FLEESON-DASILVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:FLEESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1121 11TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CONWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15027-1400
Mailing Address - Country:US
Mailing Address - Phone:724-869-2167
Mailing Address - Fax:724-869-2168
Practice Address - Street 1:1121 11TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CONWAY
Practice Address - State:PA
Practice Address - Zip Code:15027-1400
Practice Address - Country:US
Practice Address - Phone:724-869-2167
Practice Address - Fax:724-869-2168
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFL1804731OtherHIGHMARK
PAFL1804731OtherHIGHMARK
PA099499VGJMedicare PIN