Provider Demographics
NPI:1801921374
Name:NEWTON, SUSAN MARY (MS CCC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARY
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MS CCC
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Mailing Address - Street 1:16 ROCCO DR
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2804
Mailing Address - Country:US
Mailing Address - Phone:631-368-3831
Mailing Address - Fax:631-261-7741
Practice Address - Street 1:1023 PULASKI RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-1948
Practice Address - Country:US
Practice Address - Phone:631-261-7740
Practice Address - Fax:631-261-7741
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY4862-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist