Provider Demographics
NPI:1972977205
Name:STEVEN SUNDERRAJ PT PC
Entity Type:Organization
Organization Name:STEVEN SUNDERRAJ PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-421-1969
Mailing Address - Street 1:32 SEVEN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3523
Mailing Address - Country:US
Mailing Address - Phone:845-405-1431
Mailing Address - Fax:212-223-0198
Practice Address - Street 1:32 SEVEN OAKS LN
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3523
Practice Address - Country:US
Practice Address - Phone:845-405-1431
Practice Address - Fax:212-223-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0346352251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400067797OtherMEDICARE PROVIDER #
NYA400067797OtherMEDICARE PROVIDER #