Provider Demographics
NPI:1508014788
Name:LINKER, SUSANA WAN (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:WAN
Last Name:LINKER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CHRYSTIE ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5042
Mailing Address - Country:US
Mailing Address - Phone:917-488-8835
Mailing Address - Fax:
Practice Address - Street 1:55 CHRYSTIE ST
Practice Address - Street 2:SUITE 403
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5042
Practice Address - Country:US
Practice Address - Phone:917-488-8835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-30
Last Update Date:2008-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist