National Provider Identifier
Sujithraj Dommaraju, MD
Sujithraj Dommaraju, MD is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Ithaca, NY and a listed phone number of (607) 277-2170.
Profile Overview
- NPI
- 1497310031
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- May 09, 2019
- Last Updated
- December 07, 2024
Practice Location
- 905 Hanshaw RD Ste C
- Ithaca, NY 14850-1549
Phone: (607) 277-2170
Specialties
- Internal Medicine Physician (207R00000X)
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1497310031
- Entity Type
- Individual
- Last Name
- Dommaraju
- First Name
- Sujithraj
- Credential
- MD
- Mailing Street Address
- 905 Hanshaw RD Ste C
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1549
- Mailing Country
- US
- Mailing Phone
- (607) 277-2170
- Practice Street Address
- 905 Hanshaw RD Ste C
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1549
- Practice Country
- US
- Practice Phone
- (607) 277-2170
- Enumeration Date
- May 09, 2019
- Last Updated
- December 07, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 07, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X), Internal Medicine Physician (207R00000X)