| Doctor Name: | PRAJAKTA SULE |
| NPI Number: | 1083053102 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 24248 |
| Business Practice Address: | 672 Old Mill Rd Suite I Millersville, MD - 211081363 |
| Business Phone Number: | 4107290630 |
| Business Fax Number: | |
| Mailing Address: | 116 Grant Ave, Apt 2 HARRISON |
| State: | NJ |
| Postal Code: | 070292502 |
| Phone Number: | 6784294855 |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2013 |
| NPI Last Update Date: | 06/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 24248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |