Provider Demographics
NPI:1568189801
Name:PINCHERA, JAY
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:PINCHERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11105 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:MOORINGSPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71060-9475
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11105 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:MOORINGSPORT
Practice Address - State:LA
Practice Address - Zip Code:71060-9475
Practice Address - Country:US
Practice Address - Phone:318-262-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide