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General NPI Number Information
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NPI Number | 1962402453
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Entity Type | Individual
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Provider Name | DORAIRAYU THAVASEELAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CARITAS HOLY FAMILY HOSPITAL 70 EAST ST.
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City | METHUEN
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State | MA
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Zip | 01844
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Country | US
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Telephone | 978-687-0151
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Fax |
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Provider Business Mailing Address
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Address Line | 60 EAST ST SUITE 400
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City | METHUEN
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State | MA
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Zip | 01844-4500
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Country | US
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Telephone | 978-689-4601
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Fax | 978-689-3096
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 44851
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License Number State | MA
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