Individual
DR. SANDEEP TIYYAGURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 GRANDVIEW AVE, SUITE 101, WATERBURY, CT 06708-2505
(203) 597-9733
(203) 597-9732
Mailing address
140 GRANDVIEW AVE, SUITE 101, WATERBURY, CT 06708-2505
(203) 597-9733
(203) 597-9732
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
048549
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/04/2008
Last updated
10/20/2010
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