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General NPI Number Information
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NPI Number | 1912648197
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Entity Type | Individual
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Provider Name | SUCHITRA MENON
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 5055 Z MAX BLVD STE 103
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City | HARRISBURG
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State | NC
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Zip | 28075-7555
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Country | US
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Telephone | 980-402-1208
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Fax |
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Provider Business Mailing Address
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Address Line | 4631 ARDMORE LN
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City | HARRISBURG
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State | NC
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Zip | 28075-0437
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P22653
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License Number State | NC
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