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Individual

DR. SHARMINI JAYAMAHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
632 ROANOKE AVENUE, EAST END NEPHROLOGY, P.C., RIVERHEAD, NY 11901
(631) 208-8270
(631) 208-8271
Mailing address
222 MANOR PL, SUITE 102, GREENPORT, NY 11944-1261
(631) 477-1755
(631) 477-1754

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
212805
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02360956
NY
Enumeration date
06/18/2006
Last updated
11/13/2012
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