MEDICARE: PERUMAL RAJA THIYAGARAJAN MD INTERNAL MEDICINE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1295694727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERUMAL RAJA THIYAGARAJAN MD INTERNAL MEDICINE PLLC

Provider Business Mailing Address
First Line	:	201 OLD COUNTRY RD STE 170
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-2732
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 OLD COUNTRY RD STE 170
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-2732
Country	:	US
Telephone Number	:	631-271-9151
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PERUMAL THIYAGARAJAN
Credential	:	MD
Telephone Number	:	631-271-9151

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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