Provider Demographics
NPI:1396314381
Name:NADARAJAH, SHEEBA RAAJ
Entity type:Individual
Prefix:
First Name:SHEEBA
Middle Name:RAAJ
Last Name:NADARAJAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4916 41ST PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-2106
Mailing Address - Country:US
Mailing Address - Phone:202-306-6048
Mailing Address - Fax:
Practice Address - Street 1:4916 41ST PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-2106
Practice Address - Country:US
Practice Address - Phone:202-306-6048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204298363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily