Provider Demographics
NPI:1760104467
Name:SAHARAN, SUMANDEEP (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SUMANDEEP
Middle Name:
Last Name:SAHARAN
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 CRESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1604
Mailing Address - Country:US
Mailing Address - Phone:716-548-9145
Mailing Address - Fax:
Practice Address - Street 1:8700 JONES MILL RD
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4729
Practice Address - Country:US
Practice Address - Phone:301-657-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist