Provider Demographics
NPI:1770889651
Name:SURA, SUNITHA RANI (MD)
Entity type:Individual
Prefix:DR
First Name:SUNITHA
Middle Name:RANI
Last Name:SURA
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 1:505 FARMINGTON AVE
Mailing Address - Street 2:SUITE 200 PEDIATRIC ENDOCRINOLOGY
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1901
Mailing Address - Country:US
Mailing Address - Phone:860-837-6700
Mailing Address - Fax:860-837-6765
Practice Address - Street 1:505 FARMINGTON AVE
Practice Address - Street 2:SUITE 200 PEDIATRIC ENDOCRINOLOGY
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1901
Practice Address - Country:US
Practice Address - Phone:860-837-6700
Practice Address - Fax:860-837-6765
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT554772080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology