Susan Austin
Individual provider Active NPI Physical Therapist · Bangor, ME
NPI 1003908336 · NPPES record last updated Jan 21, 2009
Key facts
- NPI
- 1003908336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT2565 (ME)
- Practice address
- 133 Corporate Dr
Suite 2
Bangor, ME 04401-4312 - Phone
- (207) 992-9286
- Fax
- (207) 992-9287
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunbury Primary Care, P.a. | Past | Accepting new patients | |
| Sunbury Primary Care, P.a. | Past | Accepting new patients | |
| Sunbury Primary Care, P.a. | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2565 | ME | Yes |
Addresses
Primary practice location
133 Corporate Dr
Suite 2
Bangor, ME 04401-4312
Mailing address
PO Box 921
Bangor, ME 04402-0921
Phone (207) 942-7650
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 261630099 | Medicaid | ME |
Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.