| Doctor Name: | MRS. SUSAN PATRICIA VAN DE BOGART |
| NPI Number: | 1326291279 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 6147-1 |
| Business Practice Address: | 279 Main St Suite 203 New Paltz, NY - 125611623 |
| Business Phone Number: | 8452560253 |
| Business Fax Number: | 8452560490 |
| Mailing Address: | 70 Dubois St, NEWBURGH |
| State: | NY |
| Postal Code: | 125504851 |
| Phone Number: | 8455682395 |
| Fax Number: | 8455682946 |
| NPI Enumeration Date: | 10/23/2008 |
| NPI Last Update Date: | 10/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 6147-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |