Organization
SUHRADAM MEDICAL PRACTICE, LLC
Active
Organization
SUHRADAM MEDICAL PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIMAL BABUBHAI PATEL (CEO)
(860) 438-6004
Entity
Organization
Contact information
Practice address
50 TOLL GATE RD, BERLIN, CT 06037-3606
(860) 438-6004
(860) 740-7103
Mailing address
50 TOLL GATE RD, BERLIN, CT 06037-3606
(860) 438-6004
(860) 740-7103
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
049253
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083879522
—
CT
Enumeration date
03/15/2016
Last updated
03/15/2016
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