Provider Demographics
NPI:1538138581
Name:JURAYJ, DANIEL H (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:H
Last Name:JURAYJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WOODLAND RD
Mailing Address - Street 2:SUITE 421
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1702
Mailing Address - Country:US
Mailing Address - Phone:781-665-2525
Mailing Address - Fax:781-665-1207
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:SUITE 421
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1702
Practice Address - Country:US
Practice Address - Phone:781-665-2525
Practice Address - Fax:781-665-1207
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA79804207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3164799Medicaid
MAA22322Medicare ID - Type Unspecified
MA3164799Medicaid