Provider Demographics
NPI:1790557346
Name:THYAGARAJ, SNIGDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SNIGDA
Middle Name:
Last Name:THYAGARAJ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 S PARKER RD APT 6305
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3023
Mailing Address - Country:US
Mailing Address - Phone:734-306-0268
Mailing Address - Fax:
Practice Address - Street 1:18730 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3534
Practice Address - Country:US
Practice Address - Phone:720-876-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0024634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist