Provider Demographics
NPI:1306150875
Name:SUNKARA, SUJANA (MD)
Entity type:Individual
Prefix:
First Name:SUJANA
Middle Name:
Last Name:SUNKARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 POST RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5935
Mailing Address - Country:US
Mailing Address - Phone:203-655-8749
Mailing Address - Fax:203-656-0701
Practice Address - Street 1:1500 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5935
Practice Address - Country:US
Practice Address - Phone:203-655-8749
Practice Address - Fax:203-656-0701
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52657207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program