Individual
DR. DEVARAJ JEYAMITRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
22 CHARDONNAY RD, COMMACK, NY 11725-1768
(631) 292-2610
Mailing address
22 CHARDONNAY RD, COMMACK, NY 11725-1768
(631) 292-2610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
122286-1
NY
Other
Enumeration date
12/09/2013
Last updated
03/07/2023
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