1720570005 NPI number — DR. ATPUTHANATHAN RICHARD JEYARANJAN MD

Table of content: DR. ATPUTHANATHAN RICHARD JEYARANJAN MD (NPI 1720570005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720570005 NPI number — DR. ATPUTHANATHAN RICHARD JEYARANJAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JEYARANJAN
Provider First Name:
ATPUTHANATHAN
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720570005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 BENTWORTH AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TORONTO
Provider Business Mailing Address State Name:
ONTARIO
Provider Business Mailing Address Postal Code:
M6A1P1
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1585 MARKHAM ROAD
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
SCARBOROUGH
Provider Business Practice Location Address State Name:
ONTARIO
Provider Business Practice Location Address Postal Code:
M1B2W1
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
416-222-8004
Provider Business Practice Location Address Fax Number:
416-332-9359
Provider Enumeration Date:
06/03/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD049151L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MD049151L . This is a "INTERNAL MEDICINE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com