Provider Demographics
NPI:1538298963
Name:RAJU, JAYARAJU PASMATHOOR (MD)
Entity Type:Individual
Prefix:
First Name:JAYARAJU
Middle Name:PASMATHOOR
Last Name:RAJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAYARAJU
Other - Middle Name:PASMATHOOR
Other - Last Name:RAJU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:115 JUBILEE LN
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-4401
Mailing Address - Country:US
Mailing Address - Phone:315-790-5757
Mailing Address - Fax:
Practice Address - Street 1:1400 NOYES ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3854
Practice Address - Country:US
Practice Address - Phone:315-738-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2380412084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY238041OtherMEDICAL LICENSE