Provider Demographics
NPI:1154914521
Name:SUMERISKI, OLIVIA (DPT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:SUMERISKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 ROUTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8047
Mailing Address - Country:US
Mailing Address - Phone:732-240-6060
Mailing Address - Fax:732-240-5329
Practice Address - Street 1:226 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8047
Practice Address - Country:US
Practice Address - Phone:732-240-6060
Practice Address - Fax:732-240-5329
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01990400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist