Provider Demographics
NPI:1073826251
Name:SUKHDEO, NADIA K (PA-C)
Entity type:Individual
Prefix:MS
First Name:NADIA
Middle Name:K
Last Name:SUKHDEO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BLY CT
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1706
Mailing Address - Country:US
Mailing Address - Phone:973-699-4506
Mailing Address - Fax:
Practice Address - Street 1:486 LINCOLN PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6202
Practice Address - Country:US
Practice Address - Phone:718-773-0883
Practice Address - Fax:718-773-3728
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007456-01363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical