Individual
THAMBIRAJAH NANDAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13420 JAMAICA AVE, JAMAICA, NY 11418-2619
(718) 206-6742
(718) 206-6905
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7887
(631) 454-4161
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
213544
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02048759
—
NY
Enumeration date
03/22/2006
Last updated
01/18/2013
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