National Provider Identifier
Susan M Green, OTL
Susan M Green, OTL is listed in the NPPES registry with a primary specialty of Occupational Therapist in Jamestown, NY and a listed phone number of (716) 488-2322.
Profile Overview
- NPI
- 1629091681
- Provider Type
- Individual
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- July 25, 2006
- Last Updated
- October 06, 2022
Practice Location
- 15 South Main St
- Ste 220
- Jamestown, NY 14701
Phone: (716) 488-2322
Mailing Address
- 5472 Scandia Dr
- Bemus Point, NY 14712
Specialties
- Occupational Therapist (225X00000X)
Full Record
- NPI
- 1629091681
- Entity Type
- Individual
- Last Name
- Green
- First Name
- Susan
- Middle Name
- M
- Name Prefix
- Mrs.
- Credential
- OTL
- Provider Other Last Name
- Bermingham
- Provider Other First Name
- Susan
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 5472 Scandia Dr
- Mailing City
- Bemus Point
- Mailing State
- NY
- Mailing ZIP Code
- 14712
- Mailing Country
- US
- Mailing Phone
- (716) 488-2322
- Mailing Fax
- (716) 488-2574
- Practice Street Address
- 15 South Main St
- Practice Address Line 2
- Ste 220
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701
- Practice Country
- US
- Practice Phone
- (716) 488-2322
- Practice Fax
- (716) 488-2574
- Enumeration Date
- July 25, 2006
- Last Updated
- October 06, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 06, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Occupational Therapist (225X00000X)