Provider Demographics
NPI:1831792639
Name:BENINATO, SUZANNE TOSCANO (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:TOSCANO
Last Name:BENINATO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1923
Mailing Address - Country:US
Mailing Address - Phone:610-457-1218
Mailing Address - Fax:
Practice Address - Street 1:1400 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2043
Practice Address - Country:US
Practice Address - Phone:610-457-1218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001958E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist