Provider Demographics
NPI:1083277230
Name:SOOKHAI, DAVE (RN)
Entity Type:Individual
Prefix:
First Name:DAVE
Middle Name:
Last Name:SOOKHAI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1026
Mailing Address - Country:US
Mailing Address - Phone:631-357-9174
Mailing Address - Fax:
Practice Address - Street 1:700 VETERANS MEMORIAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2929
Practice Address - Country:US
Practice Address - Phone:631-863-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY615429163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse