Susan B Port, MSCCCSLP
Individual provider Active NPI Speech-Language Pathologist · Atlantic Beach, NY
NPI 1962651208 · NPPES record last updated Sep 10, 2008
Key facts
- NPI
- 1962651208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 003086-1 (NY)
- Practice address
- 82 Oneida Ave
Atlantic Beach, NY 11509-1425 - Phone
- (516) 410-3285
- NPI assigned
- Sep 10, 2008
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 003086-1 | NY | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 003086-1 | NY | Yes |
Addresses
Primary practice location
82 Oneida Ave
Atlantic Beach, NY 11509-1425
Mailing address
82 Oneida Ave
Atlantic Beach, NY 11509-1425
Phone (516) 410-3285
Other providers in Atlantic Beach, NY
- Michael Joseph Miller
- Mweb Medical PLLC
- Nathan Begelman, MD, PC
- Nina Perchenok
- Physical Medicine and Rehabilitation Mobile PC
- Margery Ellen Rubin
- Sarnelli Speech Services
- Isabella Sarnelli
- Diane Miller Schulman
- Sherrie Glasser, MSPT-Jay Scheurer, Pta, PLLC
All providers in Atlantic Beach, NY · Speech-Language Pathologist 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 10, 2008. 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.