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General NPI Number Information
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NPI Number | 1053732990
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Entity Type | Organization
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Legal Business Name | SUNDALA INC
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 1 CLOSTER RD
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City | PALISADES
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State | NY
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Zip | 10964-1508
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Country | US
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Telephone | 347-886-9695
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CLOSTER RD
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City | PALISADES
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State | NY
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Zip | 10964-1508
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Country | US
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Telephone | 347-886-9695
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Fax |
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Authorized Official
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Title or Position | BILLING REPRESENTATIVE
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Name | MS. DEBORAH HILDERLEY
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Credential |
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Telephone | 352-683-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 018041
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License Number State | NY
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