Basic Information
Provider Information
NPI: 1407173479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JANAKIRAMAN
FirstName: RENGARAJAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 99 EAST RIVER DR.
Address2: 5TH FLOOR
City: EAST HARTFORD
State: CT
PostalCode: 061087301
CountryCode: US
TelephoneNumber: 8602824133
FaxNumber: 8602890746
Practice Location
Address1: 2 TRAP FALLS RD
Address2: STE 414
City: SHELTON
State: CT
PostalCode: 064847623
CountryCode: US
TelephoneNumber: 2039297353
FaxNumber: 2039290756
Other Information
ProviderEnumerationDate: 04/29/2010
LastUpdateDate: 09/29/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X52791CTY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X52791CTN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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