Provider Demographics
NPI:1144585613
Name:MAHALINGAM, SOWMYA (MBBS,MD)
Entity Type:Individual
Prefix:DR
First Name:SOWMYA
Middle Name:
Last Name:MAHALINGAM
Suffix:
Gender:F
Credentials:MBBS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CEDAR ST RM TE2
Mailing Address - Street 2:YNHH DEPT OF RADIOLOGY
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:203-785-5253
Mailing Address - Fax:
Practice Address - Street 1:333 CEDAR ST RM TE2
Practice Address - Street 2:YNHH DEPT OF RADIOLOGY
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-785-5253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT569812085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology