MEDICARE: SUMAM F CHEEKKAPPARAYIL FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	335698	NY

General Provider Information

NPI Number	:	1356586333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMAM F CHEEKKAPPARAYIL FNP-C

Provider Business Mailing Address
First Line	:	8641 LEFFERTS BLVD
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-2508
Country	:	US
Telephone Number	:	718-850-5858
Fax Number	:	718-850-5858

Provider Business Practice Location Address
First Line	:	8641 LEFFERTS BLVD
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-2508
Country	:	US
Telephone Number	:	718-850-5858
Fax Number	:	718-850-5858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2008
Last Update Date	:	12/04/2008

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