Healthcare Provider Details

I. General information

NPI: 1225491434
Provider Name (Legal Business Name): MARYANN M PARAYIL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 ELMER ST
WESTFIELD NJ
07090-2128
US

IV. Provider business mailing address

1 DIAMOND HILL RD
BERKELEY HEIGHTS NJ
07922-2104
US

V. Phone/Fax

Practice location:
  • Phone: 908-228-3675
  • Fax:
Mailing address:
  • Phone: 908-273-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB10547300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: