Provider Demographics
NPI:1184947293
Name:DEONARAIN, SUE (MD)
Entity type:Individual
Prefix:MS
First Name:SUE
Middle Name:
Last Name:DEONARAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SURUJDEI
Other - Middle Name:
Other - Last Name:DEONARAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 DUDLEY STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905
Mailing Address - Country:US
Mailing Address - Phone:401-330-1430
Mailing Address - Fax:401-277-0795
Practice Address - Street 1:100 BUTLER DRIVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:401-330-1430
Practice Address - Fax:401-277-0795
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program