Basic Information
| Provider Information | |||||||||
| NPI: | 1275814063 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUNDINA | ||||||||
| FirstName: | NATALIYA | ||||||||
| MiddleName: | VIKTOROVNA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FRANCONIA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075811202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 155 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | FRANCONIA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038237078 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2011 | ||||||||
| LastUpdateDate: | 01/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2142 | AK | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0993 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.