Healthcare Provider Details

I. General information

NPI: 1215458716
Provider Name (Legal Business Name): SUNITA DHUMAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 02/03/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WILLIAM ST RM 1215
NEW YORK NY
10038-5036
US

IV. Provider business mailing address

123 POPLAR ST APT 2
JERSEY CITY NJ
07307-3231
US

V. Phone/Fax

Practice location:
  • Phone: 212-509-3333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number040246
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: