Provider Demographics
NPI:1447440854
Name:RAJ, JAYAPRIYA DARSHINI (MD)
Entity type:Individual
Prefix:DR
First Name:JAYAPRIYA
Middle Name:DARSHINI
Last Name:RAJ
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 1:900 WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3498
Mailing Address - Country:US
Mailing Address - Phone:781-349-8375
Mailing Address - Fax:781-349-8246
Practice Address - Street 1:12702 N IH 35
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2609
Practice Address - Country:US
Practice Address - Phone:210-650-9660
Practice Address - Fax:210-654-1432
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8637207R00000X
MA277927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0044298-00Medicaid
FLFO745ZMedicare UPIN