Indaram, Jayasri
Indaram, Jayasri is an sole proprietor health care provider with primary practice located at 9709 101St Ave , Ozone Park NY 11416-2523. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as her primary health care specialty. Indaram, Jayasri can be contacted via phone (718) 641-5555.Contact Information
Primary practice address
9709 101St Ave
Ozone Park NY 11416-2523
Phone: (718) 641-5555
Fax: (718) 641-6677
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 193883 | New York |
Profile Details
NPI number | 1255331302 |
---|---|
LBN Legal business name | Indaram, Jayasri |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 29th, 2005 |
Last updated | Dec 5th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1255331302 | NPPES |
New York | MEDICAID | 01528252 |
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