Healthcare Provider Details

I. General information

NPI: 1073756474
Provider Name (Legal Business Name): JAMUNA KANDASAMY RAJASINGHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ROCKWOOD PL
ENGLEWOOD NJ
07631-4957
US

IV. Provider business mailing address

25 ROCKWOOD PL
ENGLEWOOD NJ
07631-4957
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-5805
  • Fax: 201-894-1956
Mailing address:
  • Phone: 201-894-5805
  • Fax: 201-894-1956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA09345400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: