Individual
SUDHA THIRUVENGADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
130 DIVISION ST, GRIFFIN HOSPITAL, MEDICAL EDUCATION, DERBY, CT 06418-1326
(203) 732-7327
Mailing address
PO BOX 1090, WINDSOR, CT 06095-6190
(203) 755-4577
(203) 756-3628
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53971
CT
Other
Enumeration date
07/02/2012
Last updated
10/28/2021
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