Provider Demographics
NPI:1548510639
Name:GEORGE, SUMI
Entity type:Individual
Prefix:
First Name:SUMI
Middle Name:
Last Name:GEORGE
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 1:6 SWAYNE CT
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1119
Mailing Address - Country:US
Mailing Address - Phone:516-778-3934
Mailing Address - Fax:
Practice Address - Street 1:239 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1515
Practice Address - Country:US
Practice Address - Phone:516-850-3574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-15
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017535225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist