Provider Demographics
NPI:1487666269
Name:KUMTA, JAYSHREE NARSING (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYSHREE
Middle Name:NARSING
Last Name:KUMTA
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 1:420 RIVER ROAD
Mailing Address - Street 2:APARTMENT K-6
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1256
Mailing Address - Country:US
Mailing Address - Phone:973-635-2691
Mailing Address - Fax:
Practice Address - Street 1:420 RIVER ROAD
Practice Address - Street 2:APARTMENT K-6
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-1256
Practice Address - Country:US
Practice Address - Phone:973-635-2691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07283600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI25928Medicare UPIN
NJ088613MHJMedicare ID - Type Unspecified