Provider Demographics
NPI:1003934449
Name:DEY, SUJOYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUJOYA
Middle Name:
Last Name:DEY
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 1:2 BON AIR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1141
Mailing Address - Country:US
Mailing Address - Phone:415-927-0666
Mailing Address - Fax:415-927-6168
Practice Address - Street 1:2 BON AIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1141
Practice Address - Country:US
Practice Address - Phone:415-927-0666
Practice Address - Fax:415-927-6168
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104399207R00000X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA 104399OtherCALIFORNIA MEDICAL BOARD LICENSE NUMBER
MI4301080717OtherMICHIGAN MEDICAL LICENSE