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General NPI Number Information
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NPI Number | 1659598464
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Entity Type | Individual
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Provider Name | MARIA THANJAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 19815 HORACE HARDING EXPY
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-1732
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Country | US
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Telephone | 718-670-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 300 MAMARONECK AVE APT 811
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1420
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Country | US
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Telephone | 917-680-1512
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 232677
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License Number State | NY
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