Provider Demographics
NPI:1164831442
Name:KURUP, JAYASHREE
Entity Type:Individual
Prefix:DR
First Name:JAYASHREE
Middle Name:
Last Name:KURUP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9406 RILEY PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1337
Mailing Address - Country:US
Mailing Address - Phone:301-213-3481
Mailing Address - Fax:
Practice Address - Street 1:7607 GREENBELT RD
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3404
Practice Address - Country:US
Practice Address - Phone:301-441-8811
Practice Address - Fax:301-474-6724
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist