Provider Demographics
NPI:1306914684
Name:PHILIP, SUNNY (PT)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:
Last Name:PHILIP
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 COUNTY CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3031
Mailing Address - Country:US
Mailing Address - Phone:914-437-8820
Mailing Address - Fax:
Practice Address - Street 1:727 10TH ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5501
Practice Address - Country:US
Practice Address - Phone:201-864-5252
Practice Address - Fax:201-864-9955
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00810100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist