Provider Demographics
NPI:1437579182
Name:SAWANT, SUHA
Entity Type:Individual
Prefix:
First Name:SUHA
Middle Name:
Last Name:SAWANT
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 1:1647 E JEFFERSON ST
Mailing Address - Street 2:APT T2
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4065
Mailing Address - Country:US
Mailing Address - Phone:202-285-8898
Mailing Address - Fax:
Practice Address - Street 1:1647 E JEFFERSON ST
Practice Address - Street 2:APT T2
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4065
Practice Address - Country:US
Practice Address - Phone:202-285-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist