Individual
DR. SUPRIYA MARUTI TIGADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 679-3343
(860) 679-4256
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 679-3343
(860) 679-4256
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51029
CT
207RC0000X
Cardiovascular Disease Physician
Primary
051029
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51029
LICENSE
CT
Enumeration date
10/22/2009
Last updated
09/29/2022
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