Provider Demographics
NPI:1205863651
Name:UMAPATHY, JAYASHREE P (BS)
Entity Type:Individual
Prefix:
First Name:JAYASHREE
Middle Name:P
Last Name:UMAPATHY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:31370 HARPER
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-2450
Mailing Address - Country:US
Mailing Address - Phone:586-285-0545
Mailing Address - Fax:586-279-1700
Practice Address - Street 1:31370 HARPER
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-2450
Practice Address - Country:US
Practice Address - Phone:586-285-0545
Practice Address - Fax:586-279-1700
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501007610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501007610Medicare UPIN