Provider Demographics
NPI:1629361787
Name:PERINCHERI, SUDHIR (MBBS, PHD)
Entity Type:Individual
Prefix:
First Name:SUDHIR
Middle Name:
Last Name:PERINCHERI
Suffix:
Gender:M
Credentials:MBBS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208023
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8023
Mailing Address - Country:US
Mailing Address - Phone:203-785-2788
Mailing Address - Fax:203-785-7146
Practice Address - Street 1:20 YORK ST # EP2-631
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-785-2788
Practice Address - Fax:203-785-7146
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT55811207ZP0102X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology