| Doctor Name: | DR. SUSAN ELLEN PIVKO |
| NPI Number: | 1861529737 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT, CERT MDT |
| License Number: | 40QAO0717800 |
| Business Practice Address: | 1199 Pleasant Valley Way West Orange, NJ - 070521424 |
| Business Phone Number: | 9737313600 |
| Business Fax Number: | 9732436842 |
| Mailing Address: | 6 Greenwood Dr, MILLBURN |
| State: | NJ |
| Postal Code: | 070411430 |
| Phone Number: | 9734671107 |
| Fax Number: | 9734671107 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 10/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QAO0717800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| 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 |