Provider Demographics
NPI:1063727865
Name:SANTHA T. KURIEN, MD PC
Entity type:Organization
Organization Name:SANTHA T. KURIEN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTHA
Authorized Official - Middle Name:T
Authorized Official - Last Name:KURIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-743-3833
Mailing Address - Street 1:27 HOSPITAL AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5954
Mailing Address - Country:US
Mailing Address - Phone:203-743-3833
Mailing Address - Fax:203-797-0107
Practice Address - Street 1:27 HOSPITAL AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5954
Practice Address - Country:US
Practice Address - Phone:203-743-3833
Practice Address - Fax:203-797-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018560251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT260000587Medicare PIN