Healthcare Provider Details

I. General information

NPI: 1326536053
Provider Name (Legal Business Name): NEHA JEJURIKAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

NYU LANGONE MEDICAL CENTER 550 FIRST AVE.
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number1019145
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: