Provider Demographics
NPI:1891727327
Name:HANJURA, SUNITA K (MD)
Entity type:Individual
Prefix:
First Name:SUNITA
Middle Name:K
Last Name:HANJURA
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 1:450 BEDFORD STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420
Mailing Address - Country:US
Mailing Address - Phone:781-274-6274
Mailing Address - Fax:781-862-1472
Practice Address - Street 1:450 BEDFORD STREET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420
Practice Address - Country:US
Practice Address - Phone:781-274-6274
Practice Address - Fax:701-862-1472
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222935207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF27074Medicare UPIN