| Doctor Name: | SUZETTE MANTARING-HARRIS |
| NPI Number: | 1750684585 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 004890 |
| Business Practice Address: | 1445 E Putnam Ave 2nd Floor Old Greenwich, CT - 068701379 |
| Business Phone Number: | 2039835748 |
| Business Fax Number: | 2038694420 |
| Mailing Address: | 1445 E Putnam Ave, 2nd Floor OLD GREENWICH |
| State: | CT |
| Postal Code: | 068701379 |
| Phone Number: | 2039835748 |
| Fax Number: | 2038694420 |
| NPI Enumeration Date: | 12/16/2010 |
| NPI Last Update Date: | 12/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 004890 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |