Individual
DR. JAIKUMAR RAVUNNIARATH MENON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
38 WILDWOOD DR, POUGHKEEPSIE, NY 12603
(845) 594-8895
Mailing address
38 WILDWOOD DR, POUGHKEEPSIE, NY 12603
(845) 594-8895
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
251537
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002544
—
NY
01
—
363260
MVP
NY
Enumeration date
05/16/2006
Last updated
07/14/2022
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