Provider Demographics
NPI:1033110853
Name:ZAYOUD, RAJAA (MD)
Entity Type:Individual
Prefix:
First Name:RAJAA
Middle Name:
Last Name:ZAYOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NYSSA
Mailing Address - State:OR
Mailing Address - Zip Code:97913-3815
Mailing Address - Country:US
Mailing Address - Phone:541-372-5738
Mailing Address - Fax:541-372-5732
Practice Address - Street 1:17 S 3RD ST
Practice Address - Street 2:
Practice Address - City:NYSSA
Practice Address - State:OR
Practice Address - Zip Code:97913-3815
Practice Address - Country:US
Practice Address - Phone:541-372-5738
Practice Address - Fax:541-372-5732
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23964207Q00000X
NJ25MA08105800207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0130630Medicaid