Provider Demographics
NPI:1184858920
Name:SUNICO, CELSA SOCORRO (PT)
Entity Type:Individual
Prefix:MRS
First Name:CELSA
Middle Name:SOCORRO
Last Name:SUNICO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-2421
Mailing Address - Country:US
Mailing Address - Phone:914-237-2461
Mailing Address - Fax:914-237-2461
Practice Address - Street 1:103 VERNON AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2421
Practice Address - Country:US
Practice Address - Phone:914-237-2461
Practice Address - Fax:914-237-2461
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist