Individual
RAEYSHA SURENDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
6 TECHNOLOGY DR, EAST SETAUKET, NY 11733-4079
(631) 689-4197
Mailing address
366 BROADWAY, AMITYVILLE, NY 11701-2784
(937) 312-7909
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004792
NY
Other
Enumeration date
08/12/2024
Last updated
09/15/2024
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