Provider Information for 1659728491
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Dr. CHINDHURI SELVADURAI M.D.
Sex: Female
NPI: 1659728491
Last Updated: 2023-01-17
Certification Date: 2023-01-17
Certification Date: 2023-01-17
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659728491 | ||||||||||||||
| Enumeration Date | 2016-05-23 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 263 FARMINGTON AVENUE FARMINGTON, CT 06030-8031 United States Phone: 860-679-4888 | Fax:860-679-0134 | ||||||||||||||
| Primary Practice Address | 263 FARMINGTON AVENUE FARMINGTON, CT 06030-8031 United States Phone: 860-679-4888 | Fax:860-679-0134 | ||||||||||||||
| Secondary Practice Address(es) | 15 YORK ST | ||||||||||||||
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