Basic Information
| Provider Information | |||||||||
| NPI: | 1093439986 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GAUR | ||||||||
| FirstName: | SUKRITIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 MONTERO DR | ||||||||
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| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314059496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048349113 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 EISENHOWER DR STE H | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314062601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123351650 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2022 | ||||||||
| LastUpdateDate: | 10/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | OT007361 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.