Provider Demographics
NPI:1912053810
Name:GELFMAN, SUSAN CAMPBELL (OTR)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CAMPBELL
Last Name:GELFMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 STONE ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2125
Mailing Address - Country:US
Mailing Address - Phone:781-784-4029
Mailing Address - Fax:
Practice Address - Street 1:20 STONE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-2125
Practice Address - Country:US
Practice Address - Phone:781-784-4029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1039225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69388Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER