Provider Demographics
NPI:1083665053
Name:SEENIVASAN, THANGAMANI (MD)
Entity Type:Individual
Prefix:
First Name:THANGAMANI
Middle Name:
Last Name:SEENIVASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 REHILL AVENUE
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2500
Mailing Address - Country:US
Mailing Address - Phone:908-725-2400
Mailing Address - Fax:908-927-8990
Practice Address - Street 1:30 REHILL AVENUE
Practice Address - Street 2:SUITE 3400
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2500
Practice Address - Country:US
Practice Address - Phone:908-725-2400
Practice Address - Fax:908-927-8990
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO75495662086X0206X
NJ25MA069381002086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ071807BP7Medicare UPIN
H90713Medicare UPIN