Provider Demographics
NPI:1669487245
Name:ARUMUGAM, VASANTHI (MD)
Entity Type:Individual
Prefix:
First Name:VASANTHI
Middle Name:
Last Name:ARUMUGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17227 HIGHLAND AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2800
Mailing Address - Country:US
Mailing Address - Phone:718-558-9070
Mailing Address - Fax:718-558-9878
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:ROOM A1-9
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-4952
Practice Address - Fax:718-334-4815
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY209723207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02098002Medicaid
NYH21266Medicare UPIN
NY5388UPMedicare PIN
NY02098002Medicaid