Provider Demographics
NPI:1578894580
Name:SUMCHAI, AYESHA (RN)
Entity Type:Individual
Prefix:MS
First Name:AYESHA
Middle Name:
Last Name:SUMCHAI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 E 10TH ST
Mailing Address - Street 2:#4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-4825
Mailing Address - Country:US
Mailing Address - Phone:212-564-3722
Mailing Address - Fax:212-564-7517
Practice Address - Street 1:277 E 10TH ST
Practice Address - Street 2:#4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-4825
Practice Address - Country:US
Practice Address - Phone:212-564-3722
Practice Address - Fax:212-564-7517
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316747172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker