Provider Demographics
NPI:1962119677
Name:SUHAIL, AYESHA
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:
Last Name:SUHAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9207 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3320
Mailing Address - Country:US
Mailing Address - Phone:267-506-1610
Mailing Address - Fax:
Practice Address - Street 1:9207 BIRCH DR
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3320
Practice Address - Country:US
Practice Address - Phone:267-506-1610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist