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General NPI Number Information
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NPI Number | 1225904592
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Entity Type | Individual
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Provider Name | JONAH EDWARD SUDLER
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Gender |
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 6525 LANCASTER PIKE
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City | HOCKESSIN
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State | DE
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Zip | 19707-9582
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Country | US
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Telephone | 302-998-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 6525 LANCASTER PIKE
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City | HOCKESSIN
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State | DE
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Zip | 19707-9582
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Country | US
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Telephone | 302-998-0181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | J2-0011618
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License Number State | DE
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