Provider Demographics
NPI:1558940007
Name:THIAGARAJAN, PRAVEENA SHREE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:PRAVEENA
Middle Name:SHREE
Last Name:THIAGARAJAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5385 PEACH DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9541
Mailing Address - Country:US
Mailing Address - Phone:330-475-9816
Mailing Address - Fax:
Practice Address - Street 1:5385 PEACH DR
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9541
Practice Address - Country:US
Practice Address - Phone:330-475-9816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program