| Doctor Name: | SUNDEEPKUMAR VENKATESAN |
| NPI Number: | 1114281763 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CCC-SLP |
| License Number: | 106289 |
| Business Practice Address: | 2510 Westchester Ave Ste 102 Bronx, NY - 104613512 |
| Business Phone Number: | 7185975558 |
| Business Fax Number: | |
| Mailing Address: | 125 Radford St Apt 1b, YONKERS |
| State: | NY |
| Postal Code: | 107053011 |
| Phone Number: | 6469450009 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2012 |
| NPI Last Update Date: | 06/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 106289 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |