Provider Demographics
NPI:1477509511
Name:RAJAN, JENNIFER RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RAY
Last Name:RAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11 FRIENDS LN STE 115
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1885
Mailing Address - Country:US
Mailing Address - Phone:609-799-1600
Mailing Address - Fax:609-799-7617
Practice Address - Street 1:11 FRIENDS LN STE 115
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1885
Practice Address - Country:US
Practice Address - Phone:609-799-1600
Practice Address - Fax:609-799-7617
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068928L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG79678Medicare UPIN
PA072831PNTMedicare ID - Type Unspecified