Provider Demographics
NPI:1174391718
Name:SUDAN, ABINAS KOUR
Entity type:Individual
Prefix:
First Name:ABINAS
Middle Name:KOUR
Last Name:SUDAN
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 1:1 WRIGHT PL
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-2301
Mailing Address - Country:US
Mailing Address - Phone:609-937-4490
Mailing Address - Fax:
Practice Address - Street 1:1 WRIGHT PL
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-2301
Practice Address - Country:US
Practice Address - Phone:609-937-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist