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Individual

DEEPA R JAYARAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 737-1947
Mailing address
37 LOOMIS PL, NEW HAVEN, CT 06511-2222
(203) 999-3158

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301094006
MI
207RN0300X
Nephrology Physician
30870
AZ
207RN0300X
Nephrology Physician
4301094006
MI
207RN0300X
Nephrology Physician
Primary
69997
CT

Other

Enumeration date
03/10/2009
Last updated
09/11/2023
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