Provider Demographics
NPI:1598479271
Name:JAYE HEALTHCARE
Entity Type:Organization
Organization Name:JAYE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-824-3598
Mailing Address - Street 1:9737 EUSTICE RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2511
Mailing Address - Country:US
Mailing Address - Phone:443-824-3598
Mailing Address - Fax:
Practice Address - Street 1:9737 EUSTICE RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2511
Practice Address - Country:US
Practice Address - Phone:443-824-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care