Provider Demographics
NPI:1376670646
Name:NARAYANSWAMY, GAYETHRI (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYETHRI
Middle Name:
Last Name:NARAYANSWAMY
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 1:2701 TAMARACK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5561
Mailing Address - Country:US
Mailing Address - Phone:860-375-5141
Mailing Address - Fax:860-896-8190
Practice Address - Street 1:2701 TAMARACK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5561
Practice Address - Country:US
Practice Address - Phone:860-375-5141
Practice Address - Fax:860-896-8190
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229642207Q00000X
CT047731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008003848Medicaid
CT1083690OtherCIGNA
CT9097377OtherAETNA
CT008003848Medicaid