MEDICARE: DR. SUDIPTA DEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036462	CT

General Provider Information

NPI Number	:	1538103833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUDIPTA DEY M.D.

Provider Business Mailing Address
First Line	:	45 PINES BRIDGE RD
Second Line	:
City	:	BEACON FALLS
State	:	CT
Zip	:	06403-1015
Country	:	US
Telephone Number	:	203-881-2757
Fax Number	:	203-881-2639

Provider Business Practice Location Address
First Line	:	45 PINES BRIDGE RD
Second Line	:
City	:	BEACON FALLS
State	:	CT
Zip	:	06403-1015
Country	:	US
Telephone Number	:	203-881-2757
Fax Number	:	203-881-2639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/08/2007

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