Individual
SUNI JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2543 DIXWELL AVE, HAMDEN, CT 06514-1860
(203) 230-4160
Mailing address
161 ROCHELA DR, SOUTHINGTON, CT 06489-4671
(203) 525-5561
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
003301
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008043065
—
CT
Enumeration date
11/30/2005
Last updated
04/06/2023
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