Individual
KANDHASAMY JAGATHAMBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
330 WASHINGTON ST, STE 220 EASTERN CT HEMATOLOGY & ONCOLOGY, NORWICH, CT 06360-2700
(860) 886-8362
(860) 886-9262
Mailing address
330 WASHINGTON ST, STE 220 EASTERN CT HEMATOLOGY & ONCOLOGY, NORWICH, CT 06360-2700
(860) 886-8362
(860) 886-9262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
030513
CT
207RH0003X
Hematology & Oncology Physician
Primary
030513
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001305136
—
CT
01
—
010030513CT02
BC BS
CT
01
—
0113958
AETNA
CT
Enumeration date
12/13/2005
Last updated
07/22/2013
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