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General NPI Number Information
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NPI Number | 1851748438
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Entity Type | Individual
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Provider Name | GILLIAN V KUPAKUWANA-SUK M.D., PHD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 15 YORK ST YNHH DEPT OF MEDICINE, LMP 1092
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City | NEW HAVEN
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State | CT
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Zip | 06510-3221
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Country | US
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Telephone | 203-688-5555
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT. OF MEDICINE MEDICAL SERVICE GROUP 750 E. ADAMS ST.
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City | SYRACUSE
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State | NY
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Zip | 13210
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Country | US
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Telephone | 315-464-8200
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Fax | 315-464-8206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 298769
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 298769
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License Number State | NY
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