Provider Demographics
NPI:1639271430
Name:ARUMUGARAJAH, KANAGASABAPATHY (MD)
Entity Type:Individual
Prefix:
First Name:KANAGASABAPATHY
Middle Name:
Last Name:ARUMUGARAJAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W KING ST
Mailing Address - Street 2:
Mailing Address - City:LITTLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17340-1447
Mailing Address - Country:US
Mailing Address - Phone:717-359-7114
Mailing Address - Fax:717-359-7114
Practice Address - Street 1:10 W KING ST
Practice Address - Street 2:
Practice Address - City:LITTLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:17340-1447
Practice Address - Country:US
Practice Address - Phone:717-359-7114
Practice Address - Fax:717-359-7114
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038646L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008325720003Medicaid
PAAR33075Medicare ID - Type Unspecified
PA0008325720003Medicaid