Provider Demographics
NPI:1447590716
Name:JAY SHREE KRISHNA PISCATAWAY LLC
Entity Type:Organization
Organization Name:JAY SHREE KRISHNA PISCATAWAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:PANCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:IT ENGINEERMANAGEMET
Authorized Official - Phone:973-202-5072
Mailing Address - Street 1:201 CIRCLE DR N
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3723
Mailing Address - Country:US
Mailing Address - Phone:973-202-5072
Mailing Address - Fax:973-882-3162
Practice Address - Street 1:201 CIRCLE DR N
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3723
Practice Address - Country:US
Practice Address - Phone:973-202-5072
Practice Address - Fax:973-882-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care