Individual
DR. PRABAKAR THYAGARAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 GRANITE STREET,, BAYRIDGE HOSPITAL,, LYNN, MA 01904
(781) 477-6930
Mailing address
60 GRANITE STREET,, BAYRIDGE HOSPITAL,, LYNN, MA 01904
(781) 477-6930
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
152460
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3163326
—
MA
Enumeration date
12/15/2006
Last updated
07/08/2007
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