Provider Information for 1831619071
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IRINA SUNDUKOVA
Sex: Female
NPI: 1831619071
Last Updated: 2017-06-20
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1831619071 | ||||||||
| Enumeration Date | 2017-06-20 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2005 CABOR BLVD W SUITE 100 LANGHORNE, PA 19047 United States Phone: 267-587-2300 | Fax: | ||||||||
| Primary Practice Address | 1517 DURHAM ROAD PENNDEL, PA 19047 United States Phone: 267-587-2300 | Fax: | ||||||||
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