Provider Demographics
NPI:1144692120
Name:KLADNY, SUSAN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KLADNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST STE 1250
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4419
Mailing Address - Country:US
Mailing Address - Phone:412-882-1313
Mailing Address - Fax:
Practice Address - Street 1:833 CHESTNUT ST STE 1250
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4419
Practice Address - Country:US
Practice Address - Phone:412-882-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000103170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS