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General NPI Number Information
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NPI Number | 1033436530
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Entity Type | Individual
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Provider Name | THIRUVENGADAM MUNIRAJ MD PHD FRCP (LONDON)
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Gender | Male
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 09/10/2022
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Provider Practice Location Address
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Address Line | 35 PARK ST YALE NEW HAVEN HOSPITAL, SMILOW CANCER CENTER
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 203-200-5083
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Fax | 203-200-2235
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Provider Business Mailing Address
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Address Line | 15 YORK ST, STE LMP 1080 DEPARTMENT OF MEDICINE (DIGESTIVE DISEASES)
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-200-5083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 50095
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 50095
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License Number State | CT
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