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NPI Code Detail

MEDICARE: SUNAINA RAO JAIN PHD

MEDICARE: SUNAINA RAO JAIN PHD
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
1103T00000XPsychologistPSY000696GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629126156
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNAINA RAO JAIN PHD
Provider Business Mailing Address
First Line : 120 EAST TRINITY PLACE
Second Line :
City : DECATUR
State : GA
Zip : 30030-3302
Country : US
Telephone Number : 404-378-2300
Fax Number : 404-378-2394
Provider Business Practice Location Address
First Line : 120 EAST TRINITY PLACE
Second Line :
City : DECATUR
State : GA
Zip : 30030-3302
Country : US
Telephone Number : 404-378-2300
Fax Number : 404-378-2394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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