Provider Demographics
NPI:1154029791
Name:MOKADAM, SUNITA OGALE (PT)
Entity type:Individual
Prefix:MRS
First Name:SUNITA
Middle Name:OGALE
Last Name:MOKADAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 CRAFTON PARK
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3694
Mailing Address - Country:US
Mailing Address - Phone:206-280-9593
Mailing Address - Fax:
Practice Address - Street 1:4590 KNIGHTSBRIDGE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4326
Practice Address - Country:US
Practice Address - Phone:614-453-9866
Practice Address - Fax:614-326-0079
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH017848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist