Provider Demographics
NPI:1194099705
Name:DORAI, JAIGANESH (MD)
Entity type:Individual
Prefix:
First Name:JAIGANESH
Middle Name:
Last Name:DORAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16 W MAXWELL DR
Mailing Address - Street 2:WEST HARTFORD
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1441
Mailing Address - Country:US
Mailing Address - Phone:347-268-7127
Mailing Address - Fax:
Practice Address - Street 1:277 PLEASANT ST
Practice Address - Street 2:FALL RIVER
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:508-672-2836
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2013-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT050660207R00000X
MA259495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT03031979OtherDATE OF BIRTH