Individual
DR. SHINE KOCHUKUNJU RAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
UCONN HEALTH CTR, 263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(516) 943-2400
Mailing address
83 LEAFWOOD LN, APT 220, GROTON, CT 06340-6250
(516) 943-2400
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/01/2011
Last updated
04/01/2014
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