Individual
SUDESHNA BASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 RETREAT AVENUE, HARTFORD HOSPITAL CHILD PSYCHIATRY, HARTFORD, CT 06106-3310
(860) 545-7493
Mailing address
P.O. BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
049663
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001496637
—
CT
Enumeration date
08/05/2007
Last updated
04/02/2012
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