Active NPI
Suzanne J Zelasko, P.T.
- Physical Therapist
- Wyandotte, MI
National Provider Identifier
1114092095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501001540
- Practice address
- 3200 Biddle St FL 3
Wyandotte, MI 48192-5937 - Phone
- (743) 324-3963
- Fax
- (734) 324-3918
- NPI assigned
- Nov 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501001540 | MI | Primary |
Addresses
Primary practice location
3200 Biddle St FL 3
Wyandotte, MI 48192-5937
Mailing address
2940 Syckelmoore St
Trenton, MI 48183-3527
Phone (734) 676-2999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501001540 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114092095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 SYCKELMOORE ST",
"city": "TRENTON",
"state": "MI",
"postal_code": "481833527",
"telephone_number": "734-676-2999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 BIDDLE ST FL 3",
"city": "WYANDOTTE",
"state": "MI",
"postal_code": "481925937",
"telephone_number": "743-324-3963",
"fax_number": "734-324-3918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZELASKO",
"first_name": "SUZANNE",
"middle_name": "J",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501001540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyandotte, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.