Provider Demographics
NPI:1447357090
Name:LANDERS-SIMON, SUSAN JANE (PT, PCS)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:JANE
Last Name:LANDERS-SIMON
Suffix:
Gender:F
Credentials:PT, PCS
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:JANE
Other - Last Name:LANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:373 PARKER DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1323
Mailing Address - Country:US
Mailing Address - Phone:412-561-1188
Mailing Address - Fax:
Practice Address - Street 1:373 PARKER DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-1323
Practice Address - Country:US
Practice Address - Phone:412-561-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-006531-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist