Provider Demographics
NPI:1912100926
Name:WINDSOR INTERNAL MEDICINE AND GERIATRIA
Entity Type:Organization
Organization Name:WINDSOR INTERNAL MEDICINE AND GERIATRIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANUSUYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEYAKUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-448-5222
Mailing Address - Street 1:659 ABBINGTON DR STE 108
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5836
Mailing Address - Country:US
Mailing Address - Phone:609-448-5222
Mailing Address - Fax:609-396-4378
Practice Address - Street 1:659 ABBINGTON DR STE 108
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-5836
Practice Address - Country:US
Practice Address - Phone:609-448-5222
Practice Address - Fax:609-396-4378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076504Medicare ID - Type Unspecified