Provider Demographics
NPI:1457373250
Name:HOOVER, SUSAN FRANCES (PT)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:FRANCES
Last Name:HOOVER
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 1:2008 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-4304
Mailing Address - Country:US
Mailing Address - Phone:585-467-1422
Mailing Address - Fax:585-467-1434
Practice Address - Street 1:2008 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-4304
Practice Address - Country:US
Practice Address - Phone:585-467-1422
Practice Address - Fax:585-467-1434
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7003194OtherAETNA
NYFA0544OtherPREFERRED CARE HMO
R54951Medicare UPIN
NY7003194OtherAETNA