Provider Demographics
NPI:1356596795
Name:KAUFMAN, SUZANNE BETH (COTA/L)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:BETH
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 TREETOP CIR
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1021
Mailing Address - Country:US
Mailing Address - Phone:845-548-1631
Mailing Address - Fax:
Practice Address - Street 1:15 MOUNT EBO RD S
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4004
Practice Address - Country:US
Practice Address - Phone:845-940-1810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004236-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant