Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 294712 | NY |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 64267 | CT |
NPI | 1184112203 |
---|---|
Provider Name | Dr. He Sun |
First Address | Metuchen, NJ 08840-1159 |
Second Address | New Haven, CT 06510-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2018 |
Last Update Date | 11/05/2020 |