Organization
DR JAYARAM MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJIT JAYARAM M.D. (MEDICAL DIRECTOR)
(201) 369-1100
Entity
Organization
Contact information
Practice address
530 MONTGOMERY ST, JERSEY CITY, NJ 07302-3100
(201) 369-1100
Mailing address
182 ROCKWOOD PL, ENGLEWOOD, NJ 07631-5028
(201) 369-1100
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MA37221
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4747402
—
NJ
Enumeration date
04/23/2009
Last updated
04/23/2009
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