Provider Demographics
NPI:1619354727
Name:MARAN, ILAVARASY (MD)
Entity Type:Individual
Prefix:
First Name:ILAVARASY
Middle Name:
Last Name:MARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 SEYMOUR ST., JB604 UNIVERSITY OF CONNECTICUT/
Mailing Address - Street 2:HARTFORT HOSPITAL/DEPARMENT OF NEUROLOGY
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-5037
Mailing Address - Country:US
Mailing Address - Phone:860-972-5120
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR ST., JB604 UNIVERSITY OF CONNECTICUT/
Practice Address - Street 2:HARTFORT HOSPITAL/DEPARMENT OF NEUROLOGY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-5037
Practice Address - Country:US
Practice Address - Phone:860-972-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program