Provider Demographics
NPI:1912296427
Name:JADEJA, PRIYA HARI (MD)
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:HARI
Last Name:JADEJA
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 PARK AVE
Mailing Address - Street 2:APARTMENT PH4D
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3768
Mailing Address - Country:US
Mailing Address - Phone:352-613-0991
Mailing Address - Fax:
Practice Address - Street 1:75 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4532
Practice Address - Country:US
Practice Address - Phone:973-436-1530
Practice Address - Fax:973-422-0414
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284068208600000X
390200000X
NJ25MA10061900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program