Provider Demographics
NPI:1285384909
Name:SUNSERI, BAILEY ALONDRA (LPTA)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:ALONDRA
Last Name:SUNSERI
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42310 ATMORE PL
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-5827
Mailing Address - Country:US
Mailing Address - Phone:251-654-8834
Mailing Address - Fax:
Practice Address - Street 1:2625 THALIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2843
Practice Address - Country:US
Practice Address - Phone:504-503-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS6762225200000X
LAA10426R225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAA10426ROtherLOUSIANA BOARD OF PHYSICAL THERAPY
MS6762OtherMISSISSIPPI BOARD OF PHYSICAL THERAPY