1225278070 NPI number — SUSAN VERONICA RIEGER OTR/L, CHT

Table of content: SUSAN VERONICA RIEGER OTR/L, CHT (NPI 1225278070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225278070 NPI number — SUSAN VERONICA RIEGER OTR/L, CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIEGER
Provider First Name:
SUSAN
Provider Middle Name:
VERONICA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L, CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCANDREW
Provider Other First Name:
SUSAN
Provider Other Middle Name:
V.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/L, CHT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225278070
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2222 SULLIVAN TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18040-7958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-944-9782
Provider Business Mailing Address Fax Number:
610-438-2024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10790 OLD SAINT AUGUSTINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32257-1078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-260-0800
Provider Business Practice Location Address Fax Number:
904-260-3343
Provider Enumeration Date:
03/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OT2654 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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