Provider Demographics
NPI:1447339841
Name:ELCIK, SUZANNE D (OTR/L)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:D
Last Name:ELCIK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LIMERICK RD
Mailing Address - Street 2:
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046-8158
Mailing Address - Country:US
Mailing Address - Phone:207-985-7861
Mailing Address - Fax:207-985-6703
Practice Address - Street 1:39 LIMERICK RD
Practice Address - Street 2:
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046-8158
Practice Address - Country:US
Practice Address - Phone:207-985-7861
Practice Address - Fax:207-985-6703
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT128174400000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME197900000Medicaid