MEDICARE: MR. JOSHUA NAVINDRA SUKNANAN BSN, RN, CWCN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0000X	Wound Care Registered Nurse	813775	NY

General Provider Information

NPI Number	:	1730033457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA NAVINDRA SUKNANAN BSN, RN, CWCN

Provider Business Mailing Address
First Line	:	221 MONTANA AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5720
Country	:	US
Telephone Number	:	347-896-3348
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 MONTANA AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5720
Country	:	US
Telephone Number	:	347-896-3348
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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