Provider Demographics
NPI:1538102389
Name:HARID, JAYALAKSHMI (MD)
Entity Type:Individual
Prefix:
First Name:JAYALAKSHMI
Middle Name:
Last Name:HARID
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 1:1 BROOKDALE PLAZA ,
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-0096
Mailing Address - Country:US
Mailing Address - Phone:718-240-5356
Mailing Address - Fax:718-240-5367
Practice Address - Street 1:1 BROOKDALE PLAZA
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-5356
Practice Address - Fax:718-240-5367
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227190174400000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07980XMedicare PIN
NYP00479272Medicare PIN