Active NPI
Suma Sundersen Pondicherry Chandersen, PT
- Physical Therapist
- Hicksville, NY
National Provider Identifier
1891298287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 042468
- Practice address
- 16 Gardenia LN
Hicksville, NY 11801-2009 - Phone
- (917) 386-3434
- Fax
- (866) 447-4544
- NPI assigned
- Mar 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 042468 | NY | Primary |
Addresses
Primary practice location
16 Gardenia LN
Hicksville, NY 11801-2009
Mailing address
4340 Avondale LN
Cumming, GA 30041-2091
Phone (470) 695-5455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042468 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1891298287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4340 AVONDALE LN",
"city": "CUMMING",
"state": "GA",
"postal_code": "300412091",
"telephone_number": "470-695-5455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 GARDENIA LN",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118012009",
"telephone_number": "917-386-3434",
"fax_number": "866-447-4544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONDICHERRY CHANDERSEN",
"first_name": "SUMA",
"middle_name": "SUNDERSEN",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-13",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "042468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.