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General NPI Number Information
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NPI Number | 1316280803
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Entity Type | Organization
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Legal Business Name | SANG AND SRIDHAR DIGESTIVE DISEASE CONSULTANTS LLC
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 79 WAWECUS ST SUITE 102
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City | NORWICH
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State | CT
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Zip | 06360-2160
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Country | US
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Telephone | 860-859-9061
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Fax | 860-889-6200
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Provider Business Mailing Address
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Address Line | 79 WAWECUS ST SUITE 102
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City | NORWICH
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State | CT
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Zip | 06360-2160
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Country | US
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Telephone | 860-859-9061
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Fax | 860-889-6200
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Authorized Official
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Title or Position | MEMBER
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Name | DR. YOU SUNG SANG
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Credential | M.D
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Telephone | 860-859-9061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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