Healthcare Provider Details

I. General information

NPI: 1881510451
Provider Name (Legal Business Name): SKYLAR S SUNDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N MAIN ST STE 100
PITTSTON PA
18640-1949
US

IV. Provider business mailing address

37 1/2 5TH ST
WYOMING PA
18644-2137
US

V. Phone/Fax

Practice location:
  • Phone: 570-208-2787
  • Fax:
Mailing address:
  • Phone: 570-266-1857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI006644
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: