Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim Sudama

Individual provider Pediatric Occupational Therapist · NPI 1700929601

Kim Sudama is a Pediatric Occupational Therapist in Bay Shore, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
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Practice location Address checks out

1428 5th Ave
Bay Shore, NY 11706-4147
Phone: (631) 392-0081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 012854 (NY)

Record details

NPI number1700929601
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 14, 2007
Last updated in NPPESNovember 2, 2023
Certification dateNovember 2, 2023
Mailing address133 Grassy Pond Dr, Smithtown, NY 11787-4273

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