Provider Demographics
NPI:1093762197
Name:THILLAIRAJAH, NANDINI (MD)
Entity Type:Individual
Prefix:DR
First Name:NANDINI
Middle Name:
Last Name:THILLAIRAJAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 HARROGATE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1561
Mailing Address - Country:US
Mailing Address - Phone:301-365-9284
Mailing Address - Fax:301-770-2863
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-468-9225
Practice Address - Fax:301-770-2863
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052630208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics