Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 0101251483 | VA |
NPI | 1003077009 |
---|---|
Provider Name | Janine L Thekkekandam |
First Address | North Chesterfield, VA 23235-4724 |
Second Address | North Chesterfield, VA 23235-4724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 28/05/2014 |