1750727566 NPI number — MISS SUCHI V GOSALIA M.S. P.T.

Table of content: MISS SUCHI V GOSALIA M.S. P.T. (NPI 1750727566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750727566 NPI number — MISS SUCHI V GOSALIA M.S. P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOSALIA
Provider First Name:
SUCHI
Provider Middle Name:
V
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.S. P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750727566
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10201 BALTIMORE AVE
Provider Second Line Business Mailing Address:
APT 5302
Provider Business Mailing Address City Name:
COLLEGE PARK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20740-4216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-925-5249
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4922 LASALLE RD
Provider Second Line Business Practice Location Address:
#LL 03
Provider Business Practice Location Address City Name:
HYATTSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20782-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-864-2333
Provider Business Practice Location Address Fax Number:
914-207-1162
Provider Enumeration Date:
05/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  036029 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 24717 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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