Individual
YE SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
80 S MAIN ST STE 101, MIDDLETOWN, CT 06457-3648
(860) 358-5970
(860) 358-8690
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3650
(860) 358-6000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
75478
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2019
Last updated
04/12/2024
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