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Individual
PRATHIMA K JAYARAM
Active
Individual
PRATHIMA K JAYARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
238530
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027433601
UNIVERA
NY
01
—
0414038
IHA #
NY
01
—
179749BJ
PREFERRED CARE
NY
01
—
238530-0W
WORKERS COMP
NY
01
—
P010238530
BLUE CHOICE
NY
Enumeration date
05/02/2006
Last updated
12/14/2021
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