Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SUSAN DISTASIO, D.O.
ActiveDR. SUSAN DISTASIO, D.O. is a Sports Medicine (PM&R) healthcare provider located in BRONX, New York. NPI 1700010410 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · BRONX, NY
Registration Details
- NPI Number
- 1700010410
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 8, 2009 (17.286351258226 yrs)
- Last Updated
- Aug 12, 2014
- License
-
271109 (NY)
Practice Information
- Address
-
3713 E TREMONT AVEBRONX, NY, 104652054Browse NY providers · Browse ZIP 10465
- Phone
- 7187924878
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
- Additional Specialty
- Sports Medicine (PM&R)
Other Sports Medicine (PM&R) Providers in BRONX, NY
| Name | Credential | NPI |
|---|---|---|
| DR. GAUTAM KAUSHIK KHAKHAR | M.D. | 1598898421 |
| RAKHI GARG SUTARIA | M.D. | 1801189568 |
| BITTU KURUVILLA | MD | 1154689008 |
| COREY SPECTOR | D.O. | 1891324323 |
| REA MAECA LURA | RPT | 1629775051 |
| ALECIA DUNBAR | — | 1578354270 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.