Provider Demographics
NPI:1821287939
Name:SATHASIVAM, THARMAJINI
Entity Type:Individual
Prefix:
First Name:THARMAJINI
Middle Name:
Last Name:SATHASIVAM
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 1:179 PALMDALE DR
Mailing Address - Street 2:APT:6
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4031
Mailing Address - Country:US
Mailing Address - Phone:716-697-9715
Mailing Address - Fax:
Practice Address - Street 1:179 PALMDALE DR
Practice Address - Street 2:APT:6
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-4031
Practice Address - Country:US
Practice Address - Phone:716-697-9715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program