Provider Demographics
NPI:1164711354
Name:MULUKUTLA, SARAH A (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:A
Last Name:MULUKUTLA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:DOLGONOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:29 HOSPITAL PLAZA
Mailing Address - Street 2:SUITE 602
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3602
Mailing Address - Country:US
Mailing Address - Phone:203-276-4464
Mailing Address - Fax:203-276-4468
Practice Address - Street 1:29 HOSPITAL PLAZA
Practice Address - Street 2:SUITE 602
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3602
Practice Address - Country:US
Practice Address - Phone:203-276-4464
Practice Address - Fax:203-276-4468
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT535622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology