Provider Demographics
NPI:1558317149
Name:IYER, RAJESH V (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:V
Last Name:IYER
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 1:1020A E BOAL AVE
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1509
Mailing Address - Country:US
Mailing Address - Phone:814-237-8627
Mailing Address - Fax:814-238-0083
Practice Address - Street 1:99 HIGHWAY 37
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6423
Practice Address - Country:US
Practice Address - Phone:732-557-8692
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA072355002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1353985OtherAMERIHEALTH PPO
NJ2046400000OtherAMERIHEALTH HMO
NJP2524173OtherOXFORD
NJ4197067OtherGHI
NJ7609515OtherAETNA
NJ2K0043OtherHEALTHNET
NJ8789304Medicaid
NJ1168979OtherHORIZON NJ HEALTH
NJ29753OtherUNIVERSITY HEALTH PLAN
NJ63175OtherAMERIGROUP
NJ2K0043OtherHEALTHNET
NJ8789304Medicaid