Provider Demographics
NPI:1912962374
Name:SANNA, JULIUS (DC)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:
Last Name:SANNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SULLIVAN FARMS RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-4572
Mailing Address - Country:US
Mailing Address - Phone:203-740-2500
Mailing Address - Fax:203-740-0857
Practice Address - Street 1:2 OLD NEW MILFORD RD
Practice Address - Street 2:1C
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2426
Practice Address - Country:US
Practice Address - Phone:203-740-2500
Practice Address - Fax:203-740-0857
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000086111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000086CT01OtherANTHEM BC/BS
CTT22536Medicare UPIN