Provider Demographics
NPI:1215605308
Name:AMES, SUKARI (AAS, OTA)
Entity Type:Individual
Prefix:
First Name:SUKARI
Middle Name:
Last Name:AMES
Suffix:
Gender:F
Credentials:AAS, OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GARRAGHAN DR APT 5204
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-6082
Mailing Address - Country:US
Mailing Address - Phone:845-633-2696
Mailing Address - Fax:
Practice Address - Street 1:770 EMBOUGHT RD
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-5312
Practice Address - Country:US
Practice Address - Phone:518-943-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111433-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant