Provider Demographics
NPI:1508065681
Name:SATHYAN, SHARAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARAD
Middle Name:
Last Name:SATHYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JOLLEY DR STE 203
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-4228
Mailing Address - Country:US
Mailing Address - Phone:860-769-9866
Mailing Address - Fax:
Practice Address - Street 1:35 JOLLEY DR STE 203
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-4228
Practice Address - Country:US
Practice Address - Phone:860-769-9866
Practice Address - Fax:860-769-7300
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013018911207RN0300X
NY284652207RN0300X
CT56823207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology