Healthcare Provider Details

I. General information

NPI: 1770079758
Provider Name (Legal Business Name): BELINDA JEYARAJ DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 11/19/2022
Certification Date: 11/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CROSSING BLVD STE 300
FRAMINGHAM MA
01702-5555
US

IV. Provider business mailing address

20 MYLES RD
PEABODY MA
01960-6645
US

V. Phone/Fax

Practice location:
  • Phone: 857-255-0486
  • Fax: 339-686-2561
Mailing address:
  • Phone: 781-354-9029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006921
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: