Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 50095 | CT |
N | 111NI0900X | Internist | 50095 | CT |
Y | 207RG0100X | Gastroenterologist | 50095 | CT |
NPI | 1033436530 |
---|---|
Provider Name | Dr. Thiruvengadam Muniraj |
First Address | New Haven, CT 06510-3220 |
Second Address | New Haven, CT 06510-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 05/03/2018 |