Provider Demographics
NPI:1558355743
Name:SUN, DHARINI (MD)
Entity Type:Individual
Prefix:DR
First Name:DHARINI
Middle Name:
Last Name:SUN
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 1:2080 WHITNEY AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3603
Mailing Address - Country:US
Mailing Address - Phone:203-281-6228
Mailing Address - Fax:203-248-2881
Practice Address - Street 1:2080 WHITNEY AVE STE 240
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3603
Practice Address - Country:US
Practice Address - Phone:203-281-6228
Practice Address - Fax:203-248-2881
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT39321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001393214Medicaid
CT001393214Medicaid
CT010039321CT01OtherBCS ID
CT001393214Medicaid
CTH41970Medicare UPIN
CTD400102458Medicare PIN