Provider Demographics
NPI:1295791150
Name:SUNGARIAN, ARNO S (MD)
Entity type:Individual
Prefix:
First Name:ARNO
Middle Name:S
Last Name:SUNGARIAN
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:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:67 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2657
Practice Address - Country:US
Practice Address - Phone:508-752-6381
Practice Address - Fax:508-795-0407
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220038207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110036278AMedicaid
MA110036278AMedicaid
MA80816OtherFALLON HEALTH CARE
MA970198OtherNETWORK HEALTH
MA2038226Medicaid
MAAA15033OtherHARVARD PILGRIM HEALTHCAR
MAJ27187OtherBLUE CROSS/BLUE SHIELD
A36412Medicare ID - Type Unspecified
MA5551613OtherCIGNA
MA0033786OtherNET HI
J27187Medicare UPIN