Individual
MS. SUSAN FRANCES PISANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-9835
(631) 261-4400
(631) 261-6099
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
(631) 261-6099
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
44086
NY
Other
Enumeration date
08/09/2006
Last updated
07/23/2007
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