=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013100817
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SURGICAL ASSOCIATED, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2007
-----------------------------------------------------
Last Update Date | 08/24/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 HART ST BUILDING B.
-----------------------------------------------------
City | NEW BRITAIN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06052-1743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-225-9431
-----------------------------------------------------
Fax | 860-229-1873
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 40 HART ST BUILDING B.
-----------------------------------------------------
City | NEW BRITAIN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06052-1743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-225-9431
-----------------------------------------------------
Fax | 860-229-1873
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/TREASURER
-----------------------------------------------------
Name | DR. AKELLA S.V. SARMA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 860-225-9431
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------