Provider Demographics
NPI:1922130491
Name:PARAYATH MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:PARAYATH MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PADMAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAYATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-340-3994
Mailing Address - Street 1:21 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-4409
Mailing Address - Country:US
Mailing Address - Phone:617-696-6526
Mailing Address - Fax:617-273-0323
Practice Address - Street 1:150 YORK ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1829
Practice Address - Country:US
Practice Address - Phone:781-297-6782
Practice Address - Fax:781-297-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3134148Medicaid
MA3134148Medicaid
MAJO4828Medicare ID - Type Unspecified