Individual
DR. RAJESWARI JASTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
90814
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
908147
—
SC
01
—
SCR5565019
MEDICARE PIN
SC
01
—
SCR5569068
MEDICARE PIN
SC
Enumeration date
04/01/2020
Last updated
01/03/2024
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