Provider Demographics
NPI:1447603279
Name:SULA KARRECI, ESILIDA
Entity type:Individual
Prefix:
First Name:ESILIDA
Middle Name:
Last Name:SULA KARRECI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VERPLAST AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1138
Mailing Address - Country:US
Mailing Address - Phone:857-266-6365
Mailing Address - Fax:
Practice Address - Street 1:4 VERPLAST AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1138
Practice Address - Country:US
Practice Address - Phone:857-266-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-17
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA268691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine