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General NPI Number Information
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NPI Number | 1437149317
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Entity Type | Individual
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Provider Name | SUBHA THIAGARAJAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 275 NICHOLS RD
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City | FITCHBURG
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State | MA
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Zip | 01420-1931
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Country | US
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Telephone | 978-665-5860
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9132
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City | BROOKLINE
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State | MA
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Zip | 02446-9132
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Country | US
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Telephone | 603-893-9784
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Fax | 603-890-1236
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 74856
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License Number State | MA
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