Provider Demographics
NPI:1205460490
Name:DAHIYA, SUMAN
Entity type:Individual
Prefix:
First Name:SUMAN
Middle Name:
Last Name:DAHIYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 UPDIKE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5521
Mailing Address - Country:US
Mailing Address - Phone:857-928-2247
Mailing Address - Fax:
Practice Address - Street 1:NATHANIEL WITHERELL
Practice Address - Street 2:70 PARSONAGE RD
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:08844
Practice Address - Country:US
Practice Address - Phone:857-928-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02022100225100000X
CT11725225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist