Individual
DR. SANJA DACIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD,PHD
Contact information
Practice address
310 CEDAR STREET, YSM BRADY MEMORIAL LABORATORY, NEW HAVEN, CT 06520
(203) 785-3624
Mailing address
310 CEDAR STREET PO BOX 208023, YSM BRADY MEMORIAL LABORATORY, NEW HAVEN, CT 06520
(203) 785-3624
(203) 785-7037
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD072759L
PA
207ZP0101X
Anatomic Pathology Physician
70365
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001891077
—
PA
Enumeration date
02/07/2006
Last updated
04/07/2022
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