Basic Information
| Provider Information | |||||||||
| NPI: | 1760643407 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MULAY | ||||||||
| FirstName: | SUDHANSHU | ||||||||
| MiddleName: | BHARAT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 WOODLAND ST / CANCER CENTER | ||||||||
| Address2: | SAINT FRANCIS MEDICAL GROUP INC | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061051208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607145554 | ||||||||
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| Practice Location | |||||||||
| Address1: | 114 WOODLAND STREET / CANCER CENTER | ||||||||
| Address2: | SAINT FRANCIS MEDICAL GROUP, INC | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061050000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607145554 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 11/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 052812 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.