MEDICARE: SURIYA A JEYAPALAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	159988	MA

General Provider Information

NPI Number	:	1710934450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SURIYA A JEYAPALAN M.D.

Provider Business Mailing Address
First Line	:	280 CHESTNUT ST FL 2
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 MAIN ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01107-1112
Country	:	US
Telephone Number	:	413-794-9338
Fax Number	:	413-794-9754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	06/11/2026

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