Provider Demographics
NPI:1700547403
Name:SUGA, KOHEI (PT)
Entity Type:Individual
Prefix:DR
First Name:KOHEI
Middle Name:
Last Name:SUGA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 45TH ST STE 1600
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4229
Mailing Address - Country:US
Mailing Address - Phone:917-388-2031
Mailing Address - Fax:
Practice Address - Street 1:2 W 45TH ST STE 1600
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4229
Practice Address - Country:US
Practice Address - Phone:917-388-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045564-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist