Susan Polonsky Cable, PT

Individual provider Active NPI Specialist · Sharon, MA

NPI 1003947433 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1003947433
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
1609 (MA)
Practice address
43 Greenwood Rd
Sharon, MA 02067-1232
Phone
(781) 784-5258
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1609MAMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1609 MA Yes

Addresses

Primary practice location

43 Greenwood Rd
Sharon, MA 02067-1232

Mailing address

43 Greenwood Rd
Sharon, MA 02067-1232
Phone (781) 784-5258

Other identifiers

IdentifierTypeStateIssuer
Y66610OtherMABCBS

Other providers in Sharon, MA

All providers in Sharon, MA · Specialist in Massachusetts

Sources for this page

Verify at the official NPI Registry.