Provider Demographics
NPI:1891813713
Name:JAYAKUMAR, SUNITA N (MD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:N
Last Name:JAYAKUMAR
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 1:35 PAUL DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3203
Mailing Address - Country:US
Mailing Address - Phone:201-780-5974
Mailing Address - Fax:
Practice Address - Street 1:175 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8082
Practice Address - Country:US
Practice Address - Phone:724-627-4281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437161207R00000X
NJ25MA076613002083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine