Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 010791 | CT |
Y | 1223G0001X | General Practice | 010791 | CT |
Y | 213EG0000X | General Practice | 010791 | CT |
NPI | 1003170465 |
---|---|
Provider Name | Saranya Sakhamuri |
First Address | Norwood, MA 02062-2556 |
Second Address | Waterbury, CT 06702-2205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2012 |
Last Update Date | 30/06/2012 |