Individual
JAY R THIAGARAJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS, PH.D
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6058
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6058
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
253464
MA
2080P0206X
Pediatric Gastroenterology Physician
Primary
253464
MA
Other
Enumeration date
05/20/2010
Last updated
02/22/2017
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