KANDHASAMY JAGATHAMBAL (NPI# 1043295033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043295033 |
| Entity Type | Individual |
| Full Name | KANDHASAMY JAGATHAMBAL |
| Credential | MD |
| Practice Address |
330 Washington St Ste 220 Eastern Ct Hematology & Oncology Norwich CT 06360-2700 |
| Practice Telephone | 8608868362 |
| Practice Fax Number | 8608869262 |
| Mailing Telephone | 8608868362 |
| Mailing Fax Number | 8608869262 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2013-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 030513 | CT | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
030513 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BC BS | 010030513CT02 | 01 |
| CT | AETNA | 0113958 | 01 |
| CT | 001305136 | 05 |
| Street Address |
330 WASHINGTON ST STE 220 EASTERN CT HEMATOLOGY & ONCOLOGY |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447247788 | Olimpia A Radu | Internal Medicine | 330 Washington St, Ste 430, Norwich, CT 06360-2700 | 2005-10-03 |
| 1912458704 | Allan Dierman | Nurse Practitioner | 330 Washington St, Suite 510, Norwich, CT 06360-2700 | 2016-10-17 |
| 1528467016 | Lisa Decarlo | Nurse Practitioner | 330 Washington St, Suite 510, Norwich, CT 06360-2700 | 2014-08-20 |
| 1952700197 | Maura Theresa Forte | Nurse Practitioner | 330 Washington St, Suite 510, Norwich, CT 06360-2700 | 2014-08-13 |
| 1497012520 | Erin Marie Loughery | Nurse Practitioner | 330 Washington St, Suite 350, Norwich, CT 06360-2700 | 2012-04-13 |
| 1003047481 | Melody Mukon | Physician Assistant | 330 Washington St, Suite 220, Norwich, CT 06360-2700 | 2009-08-03 |
| 1306083142 | Eastern Connecticut Neurosurgery, P.C. | Neurological Surgery | 330 Washington St, Suite 540, Norwich, CT 06360-2700 | 2009-01-15 |
| 1801032784 | Ct Podiatry & Foot Surgery, LLC | Podiatrist | 330 Washington St, Suite 310, Norwich, CT 06360-2700 | 2008-12-26 |
| 1700042900 | Joanne Cantor Friedman | Nurse Practitioner | 330 Washington St, Suite 350, Norwich, CT 06360-2700 | 2008-08-06 |
| 1447415815 | Generations Family Health Center, Inc. | Clinic/Center | 330 Washington St, Ste 510, Norwich, CT 06360-2700 | 2008-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326047549 | Vanessa M.p. Johnson | Internal Medicine | 330 Washington St Ste 220, Norwich, CT 06360 | 2005-07-19 |
| 1982047981 | Pouyan Changizzadeh | Internal Medicine | 330 Washington St Ste 220, Norwich, CT 06360-2700 | 2013-04-10 |
| 1235114273 | Robin R Watson | Internal Medicine | 330 Washington St, Eastern Ct Hematology & Oncology Suite 220, Norwich, CT 06360-2700 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154751907 | David S Fischer | Internal Medicine | 17 Abigail St, Milford, CT 06460-7918 | 2013-11-14 |
| 1265746879 | Eric Bleickardt | Internal Medicine | 3 Hidden Brook Rd, Hamden, CT 06518-1764 | 2010-08-06 |
| 1467763946 | Kelsey Thompson Martin | Internal Medicine | 240 Indian River Rd Ste A1, Orange, CT 06477-3690 | 2010-06-29 |
| 1780907295 | Kenneth L Sacks | Internal Medicine | 10 Oyster Landing Rd, Milford, CT 06460-6566 | 2010-03-11 |
| 1396981668 | Michael W Rosen | Internal Medicine | 32 Mackay Farm Rd, Woodbury, CT 06798-2509 | 2008-12-17 |
| 1083879134 | Jia Li | Internal Medicine | 950 Campbell Ave # 111d, West Haven, CT 06516-2770 | 2008-07-28 |
| 1760643407 | Sudhanshu Bharat Mulay | Internal Medicine | 114 Woodland Street / Cancer Center, Saint Francis Medical Group, Inc, Hartford, CT 06105-0000 | 2008-06-24 |
| 1194938324 | Anamika Katoch | Internal Medicine | 1075 Chase Pkwy Ste B, Harold Leever Cancer Center, Waterbury, CT 06708-2948 | 2007-05-07 |
| 1760694327 | Joseph Donadio | Internal Medicine | 140 Blue Hills Rd, Durham, CT 06422-3100 | 2007-05-04 |
| 1720136757 | Wylie David Hosmer | Internal Medicine | 55 Meriden Ave Ste 1a, Southington, CT 06489-3237 | 2007-01-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.