Imaeda, Suguru

Imaeda, Suguru is an individual health care provider with primary practice located at 55 Lock Street , New Haven CT 06520-8237. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Imaeda, Suguru can be contacted via phone (203) 432-0076.

Contact Information

Primary practice address
55 Lock Street New Haven CT 06520-8237
Fax: (203) 432-7289
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 032326 Connecticut

Profile Details

NPI number 1760472237
LBN Legal business name Imaeda, Suguru
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Dec 29th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760472237 NPPES
Connecticut MEDICAID 001323261

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