Provider Demographics
NPI:1881662328
Name:VARGO, SUSAN S (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:S
Last Name:VARGO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4115 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1887
Mailing Address - Country:US
Mailing Address - Phone:724-327-7099
Mailing Address - Fax:724-327-0173
Practice Address - Street 1:2735 MOSSIDE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2736
Practice Address - Country:US
Practice Address - Phone:412-856-8060
Practice Address - Fax:412-856-7260
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT003774L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396676Medicare Oscar/Certification