Provider Demographics
NPI:1659963601
Name:DHAKSHINAMURTHY, INDUMATHI
Entity Type:Individual
Prefix:
First Name:INDUMATHI
Middle Name:
Last Name:DHAKSHINAMURTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-2300
Mailing Address - Country:US
Mailing Address - Phone:203-685-6089
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST YALE NEW HAVEN HOSPITAL SOUTH PAVILION 218
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-688-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program