Provider Demographics
NPI:1548042021
Name:SUDAR, KIRSTEN
Entity type:Individual
Prefix:MISS
First Name:KIRSTEN
Middle Name:
Last Name:SUDAR
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 1:246 GREENLEE RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2320
Mailing Address - Country:US
Mailing Address - Phone:412-676-8502
Mailing Address - Fax:
Practice Address - Street 1:244 CENTER RD STE 301
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1789
Practice Address - Country:US
Practice Address - Phone:412-545-3063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker