Individual ProviderThayyullathil BharathanInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address263 7th Ave, Brooklyn, NY 11215(718) 246-8600PECOS EnrollmentBased on the most recent information from CMS, provider Thayyullathil Bharathan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1932152899Provider TypeIndividualFull NameBharathan, ThayyullathilCredentialMDGenderMaleSole ProprietorYesEnumeration Date5/19/2006Last Updated9/23/2011Contact InformationPractice LocationPractice Address263 7th Ave, Brooklyn, NY 11215Phone(718) 246-8600Fax(718) 246-8601Mailing LocationMailing AddressPO Box 5450, New York, NY 10087-5450Phone(718) 246-8600Fax(718) 246-8601Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense114985New YorkCode207RG0300XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense114985New YorkProvider IdentifiersIDDescriptionIssuerID00210908DescriptionMedicaidIssuerUnlistedNew York