Basic Information
| Provider Information | |||||||||
| NPI: | 1972675478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUMARASWAMI | ||||||||
| FirstName: | RAJESHKUMAR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7365 MAIN ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | STRATFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066141300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033843174 | ||||||||
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| Practice Location | |||||||||
| Address1: | 267 GRANT ST | ||||||||
| Address2: | |||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066102805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033843000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2006 | ||||||||
| LastUpdateDate: | 11/24/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 016440 | ME | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 047987 | CT | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | M1087402 | 01 | ME | CIGNA | OTHER | 3240685 | 01 | ME | AETNA | OTHER | AA16536 | 01 | ME | HPHC | OTHER | 022935 | 01 | ME | ANTHEM | OTHER | 410230099 | 05 | ME | MEDICAID |