Susan E Loomis, PT
Individual provider Active NPI Physical Therapist · Granville, NY
NPI 1104100742 · NPPES record last updated Sep 30, 2011
Key facts
- NPI
- 1104100742
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 006100-1 (NY)
- Practice address
- 61 Quaker St
Granville, NY 12832-1529 - Phone
- (518) 642-9460
- NPI assigned
- Sep 30, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006100-1 | NY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 006100-1 | NY | Yes |
Addresses
Primary practice location
61 Quaker St
Granville, NY 12832-1529
Mailing address
27 Gick Rd
Saratoga Springs, NY 12866-8517
Phone (518) 746-3605
Other providers in Granville, NY
- Irop LLC
- John Michael Javier
- Jennifer Ruth Kelley
- Melinda Renee Lewis
- Emily M Loomis
- Michael Lynch
- Caitlin McCusker
- Mettowee Valley Speech Therapy Services, PLLC
- Sadaf Shahid Mirza
- Deidra Ann Mitchell
All providers in Granville, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2011. 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.