Provider Demographics
NPI:1245315290
Name:THURAISAMY, KALPNA (DO)
Entity type:Individual
Prefix:
First Name:KALPNA
Middle Name:
Last Name:THURAISAMY
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 IYANNOUGH RD STE I10
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-8110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:1070 IYANNOUGH RD STE I10
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-8110
Practice Address - Country:US
Practice Address - Phone:508-948-3400
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242400207RA0000X, 207R00000X
NY208446207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G69625Medicare UPIN