MEDICARE: DANIELLE SUNDLOV MS, OTR/L

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	225X00000X	Occupational Therapist	4365	NC

General Provider Information

NPI Number	:	1912855719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE SUNDLOV MS, OTR/L

Provider Business Mailing Address
First Line	:	367 ARBORETUM DR APT 302
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-6301
Country	:	US
Telephone Number	:	910-512-1212
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 CAROLINA BEACH RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2908
Country	:	US
Telephone Number	:	910-254-4200
Fax Number	:

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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