Provider Demographics
NPI:1386197879
Name:THIRUMALA, SUNITHA
Entity Type:Individual
Prefix:
First Name:SUNITHA
Middle Name:
Last Name:THIRUMALA
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 1:1 STILES RD
Mailing Address - Street 2:STE 203
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4804
Mailing Address - Country:US
Mailing Address - Phone:855-390-7774
Mailing Address - Fax:855-734-4666
Practice Address - Street 1:11610 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5600
Practice Address - Country:US
Practice Address - Phone:317-818-1786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010062A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist