Provider Demographics
NPI:1659817096
Name:SUKHU, JEANETTE (RD)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:SUKHU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-0151
Mailing Address - Country:US
Mailing Address - Phone:302-652-2455
Mailing Address - Fax:302-322-6251
Practice Address - Street 1:1802 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3420
Practice Address - Country:US
Practice Address - Phone:302-224-6800
Practice Address - Fax:302-655-3541
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE-0000653133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered