Provider Demographics
NPI:1558955443
Name:NEDUNURI, SHUSHMA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SHUSHMA
Middle Name:
Last Name:NEDUNURI
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 1:3219 KRISTA LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-2125
Mailing Address - Country:US
Mailing Address - Phone:732-397-6286
Mailing Address - Fax:
Practice Address - Street 1:560 N ROUTE 100
Practice Address - Street 2:
Practice Address - City:BECHTELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19505-9228
Practice Address - Country:US
Practice Address - Phone:610-845-5000
Practice Address - Fax:610-845-5011
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist