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1700929601
KIM SUDAMA
BAY SHORE, NY
NPI
1700929601
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XP0200X Occupational Therapist Pediatrics
(Licence: NY 012854)
Enumeration Date
2007-02-14
Last Update Date
2023-11-02
Business Address
KIM SUDAMA
1428 5TH AVE
BAY SHORE, NY 11706-4147
Phone number: 631-392-0081
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Mailing Address
KIM SUDAMA
133 GRASSY POND DR
SMITHTOWN, NY 11787-4273
Phone number: 516-906-8957
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