Provider Demographics
NPI:1831216399
Name:CHUGHATTA, SUSAN LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LYNN
Last Name:CHUGHATTA
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 1:12 LOCKHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-1726
Mailing Address - Country:US
Mailing Address - Phone:908-295-4085
Mailing Address - Fax:
Practice Address - Street 1:200 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3326
Practice Address - Country:US
Practice Address - Phone:973-887-8080
Practice Address - Fax:973-386-5974
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA00989200225100000X
PAPT013567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist