Susan Ann Dorlack, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2362-024 Issued in WI

Practice address

13530 W Deer Park CT
New Berlin, WI 53151-8776

Phone

(414) 427-0052

NPI assigned

Apr 7, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1750554259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 W DEER PARK CT",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531518776",
            "telephone_number": "414-427-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 W DEER PARK CT",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531518776",
            "telephone_number": "414-427-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORLACK",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2362-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40078800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Lee Dennison, LCSW
• Stephen J. Desidero, M.D.
• Alyssa Marie Dieter, OTR/L
• Nicole Dohm, R.N.
• Cynthia L Donley, P.N.P.
• Arthur J Dorrington, M.D.
• Daniel Dorrington, M.D.
• Hamilton John Dowden, D.C.
• Alexandria R Draginis, LPC-IT
• Dominic Brian Draper, MD

• Physical Therapist in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.