Provider Demographics
NPI:1710962543
Name:RAJAN, SUJATHA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SUJATHA
Middle Name:S
Last Name:RAJAN
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 1:800 W. CUMMINGS PARK
Mailing Address - Street 2:#2550
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-460-2120
Mailing Address - Fax:781-460-2123
Practice Address - Street 1:800 W. CUMMINGS PARK
Practice Address - Street 2:#2250
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-460-2120
Practice Address - Fax:781-460-2123
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216213207VG0400X, 207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology