Provider Demographics
NPI:1689889685
Name:SUNDHEIM, JILL CAROL (OT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:CAROL
Last Name:SUNDHEIM
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 TRENTON RD
Mailing Address - Street 2:APARTMENT B16
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2717
Mailing Address - Country:US
Mailing Address - Phone:267-580-5400
Mailing Address - Fax:
Practice Address - Street 1:1480 OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5630
Practice Address - Country:US
Practice Address - Phone:215-321-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000883L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist