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Provider Information for 1659728491

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DR. CHINDHURI SELVADURAI M.D.

Gender: FEMALE

Individual NPI: 1659728491

Calendar   Last Updated:  2021-06-29
  Certification Date:  2021-06-29

Details

Name Value
NPI 1659728491
Enumeration Date 2016-05-23
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 263 FARMINGTON AVENUE
FARMINGTON, CT 06030-8031
United States

Phone: 860-679-4888 | Fax: 860-679-0134
View Map External Link
Primary Practice Address 263 FARMINGTON AVENUE
FARMINGTON, CT 06030-8031
United States

Phone: 860-679-4888 | Fax: 860-679-0134
View Map External Link
Secondary Practice Address 15 YORK ST YNHH DEPT OF MEDICINE, LMP 1092
NEW HAVEN, CT 06510-3221
United States

Phone: 203-688-9503 | Fax: 203-688-5599
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2084N0400X - Psychiatry & Neurology Neurology CT 066435
No 390200000X - Student in an Organized Health Care Education/Training Program