Individual provider Active NPI

Susan Young

  • Physical Therapist
  • Union, NJ
National Provider Identifier
1659528206
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00352500 Issued in NJ
Practice address
2625 Morris Ave
Union, NJ 07083-5665
Phone
(908) 686-0840
Fax
(908) 626-9250
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00352500 NJ Primary

Addresses

Primary practice location

2625 Morris Ave
Union, NJ 07083-5665

Mailing address

PO Box 1014
1180 Raritan Road
Clark, NJ 07066-1014
Phone (732) 855-9751

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00352500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Boro Physical Therapy Associates, PA Past Accepting new patients
Twin Boro Physical Therapy Associates PA Physical Therapist PastSince Jan 3, 2000 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1659528206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "address_2": "1180 RARITAN ROAD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661014",
            "telephone_number": "732-855-9751",
            "fax_number": "732-855-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835665",
            "telephone_number": "908-686-0840",
            "fax_number": "908-626-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00352500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.