Individual
JAYARAJU PASMATHOOR RAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1400 NOYES ST, UTICA, NY 13502-3854
(315) 738-4405
Mailing address
115 JUBILEE LN, NEW HARTFORD, NY 13413-4401
(315) 790-5757
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
238041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238041
MEDICAL LICENSE
NY
Enumeration date
03/02/2007
Last updated
06/20/2021
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