Provider Demographics
NPI:1841933991
Name:SHAUKAT, SUNNIYA BAKHT
Entity type:Individual
Prefix:
First Name:SUNNIYA
Middle Name:BAKHT
Last Name:SHAUKAT
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 1:150 N COUNTRY RD APT C6
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2178
Mailing Address - Country:US
Mailing Address - Phone:613-786-3513
Mailing Address - Fax:
Practice Address - Street 1:75 N COUNTRY RD APT C6
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2119
Practice Address - Country:US
Practice Address - Phone:631-686-2549
Practice Address - Fax:631-686-7651
Is Sole Proprietor?:No
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program