Van Der Walt, Susanna (Sunel) P
Van Der Walt, Susanna (Sunel) P is an individual health care provider with primary practice located at 5700 Harper Dr Ne Ste 250 , Albuquerque NM 87109-3588. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Van Der Walt, Susanna (Sunel) P can be contacted via phone (505) 828-2273.Contact Information
Primary practice address
5700 Harper Dr Ne Ste 250
Albuquerque NM 87109-3588
Phone: (505) 828-2273
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 4594 | New Mexico |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 4594 | New Mexico |
Profile Details
| NPI number | 1124410519 |
|---|---|
| LBN Legal business name | Van Der Walt, Susanna (Sunel) P |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2015 |
| Last updated | Jan 1st, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124410519 | NPPES |
| New Mexico | MEDICAID | 10171568 | |
| New Mexico | Other | 326556 |
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