Distasio, Susan

Distasio, Susan is an individual health care provider with primary practice located at 3713 E Tremont Ave , Bronx NY 10465-2054. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Distasio, Susan can be contacted via phone (718) 792-4878.

Contact Information

Primary practice address
3713 E Tremont Ave Bronx NY 10465-2054
Phone: (718) 792-4878
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 271109 New York

Profile Details

NPI number 1700010410
LBN Legal business name Distasio, Susan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2009
Last updated Aug 12th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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