Healthcare Provider Details

I. General information

NPI: 1346255163
Provider Name (Legal Business Name): SUNITA MURTY-GAMI MS OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1179 HARP ST
RALEIGH NC
27604-1303
US

IV. Provider business mailing address

1179 HARP ST
RALEIGH NC
27604-1303
US

V. Phone/Fax

Practice location:
  • Phone: 314-749-9654
  • Fax:
Mailing address:
  • Phone: 314-749-9654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5739
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: