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Sunrise Med LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) in Derby, CT. Organization (NPI-2).

NPI number1316629892
StatusActive
Last updated in NPPESAug 18, 2023

Details

NPI
1316629892
Entity type
Organization (NPI-2)
Legal business name
Sunrise Med LLC
Organization subpart
No
Enumeration date
Aug 3, 2023
Certification date
Aug 16, 2023
Last updated
Aug 18, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

130 Division Street
Derby, CT 06418

Phone 203-872-2131

Mailing address

1000 Boston Post Rd # 1015
Old Saybrook, CT 06475-2142

Phone 203-872-2131 · Fax 207-419-7179

Authorized official

Diana Kurlyandchik
Psychiatrist
9176030509

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