Provider Demographics
NPI:1558126714
Name:CHAUDHARY, SUSHANKI (DPT)
Entity type:Individual
Prefix:
First Name:SUSHANKI
Middle Name:
Last Name:CHAUDHARY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 OLD DOBBIN LN STE 140
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5860
Mailing Address - Country:US
Mailing Address - Phone:301-774-0500
Mailing Address - Fax:443-545-8068
Practice Address - Street 1:6240 OLD DOBBIN LN STE 140
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5860
Practice Address - Country:US
Practice Address - Phone:301-774-0500
Practice Address - Fax:443-545-8068
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist