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Individual

DR. DARRELL SUTIJONO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
464 CONGRESS AVE, SUITE 260, NEW HAVEN, CT 06519-1361
(203) 785-3637
Mailing address
120 GREENWICH ST, #9J, NEW YORK, NY 10006-1500

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
047403
CT
207P00000X
Emergency Medicine Physician
250087-1
NY
207P00000X
Emergency Medicine Physician
A106810
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/19/2007
Last updated
12/15/2021
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