Provider Demographics
NPI:1427243088
Name:IYENGAR, ANJALI RAMASWAMI (MD)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:RAMASWAMI
Last Name:IYENGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 W THUNDERBIRD RD
Mailing Address - Street 2:C300
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4660
Mailing Address - Country:US
Mailing Address - Phone:602-938-2848
Mailing Address - Fax:602-938-4606
Practice Address - Street 1:5750 W THUNDERBIRD RD
Practice Address - Street 2:C300
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4660
Practice Address - Country:US
Practice Address - Phone:602-938-2848
Practice Address - Fax:602-938-4606
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064217A207RH0003X
AZ42003207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology