Healthcare Provider Details

I. General information

NPI: 1174190698
Provider Name (Legal Business Name): SINTHUJA JAYARAJ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 LEXINGTON AVE RM 800
NEW YORK NY
10016-0942
US

IV. Provider business mailing address

405 WALTHAM ST STE 338
LEXINGTON MA
02421-7934
US

V. Phone/Fax

Practice location:
  • Phone: 917-391-0076
  • Fax: 917-477-6849
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number333735
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number1023095
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: