Active NPI
Suzanne W Fisher, PHYSICAL THERAPIST
- Physical Therapist
- Lake Luzerne, NY
National Provider Identifier
1992973713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 015266-1
- Practice address
- 273 Lake Ave.
Hadley-Luzerne Elementary School
Lake Luzerne, NY 12846-0200 - Phone
- (518) 696-2112
- NPI assigned
- Feb 14, 2008
- 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 | 015266-1 | NY | Primary |
Addresses
Primary practice location
273 Lake Ave.
Hadley-Luzerne Elementary School
Lake Luzerne, NY 12846-0200
Mailing address
PO Box 200
Cse Office
Lake Luzerne, NY 12846-0200
Phone (518) 696-2112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00752456 | Medicaid | NY |
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 |
|---|---|---|---|
| 015266-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1992973713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 200",
"address_2": "CSE OFFICE",
"city": "LAKE LUZERNE",
"state": "NY",
"postal_code": "128460200",
"telephone_number": "518-696-2112",
"fax_number": "518-696-5402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 LAKE AVE.",
"address_2": "HADLEY-LUZERNE ELEMENTARY SCHOOL",
"city": "LAKE LUZERNE",
"state": "NY",
"postal_code": "128460200",
"telephone_number": "518-696-2112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "SUZANNE",
"middle_name": "W",
"name_prefix": "Ms.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-14",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "015266-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00752456",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Luzerne, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.