Provider Demographics
NPI:1235762923
Name:SINDHUJA GUNASEKARAN, FNU (PT, DPT)
Entity Type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:SINDHUJA GUNASEKARAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11701 LIVINGSTON RD STE 202
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5136
Practice Address - Country:US
Practice Address - Phone:443-512-8337
Practice Address - Fax:443-327-5282
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1328688225100000X
MD28715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist