VICTOR JAYASUNDERA RPT NPI 1558488783

NPI Information

  • NPI: 1558488783
  • Provider Name: VICTOR JAYASUNDERA, RPT
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 23100 PROVIDENCE DR
    SUITE 135
    SOUTHFIELD, MI
    ZIP 48075
  • Phone: (248) 905-5180

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NPI Details

Victor Jayasundera, RPT is a specialist in Southfield, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Victor Jayasundera, RPT NPI is 1558488783. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

23100 PROVIDENCE DR
SUITE 135
SOUTHFIELD, MI
ZIP 48075-646
Phone: (248) 905-5180
Fax: (248) 905-5181

The enumeration date for this NPI number is 3/23/2007 and was last updated on 1/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist5501005927MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15501005927OTHERMICHIGANSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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