Individual
DR. KAVETHA SUNDARAMOORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 647-4746
(860) 647-6809
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 647-4746
(860) 647-6809
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
050243
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
8600
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004025177
—
CT
05
—
004041885
—
CT
Enumeration date
07/13/2007
Last updated
02/23/2015
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