Provider Demographics
NPI:1659660694
Name:CJA CAYEY INC.
Entity Type:Organization
Organization Name:CJA CAYEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-738-1860
Mailing Address - Street 1:P.O. BOX 3271
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-3271
Mailing Address - Country:US
Mailing Address - Phone:787-738-1860
Mailing Address - Fax:787-738-1860
Practice Address - Street 1:CALLE LUIS BARRERAS
Practice Address - Street 2:# 174
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-738-1866
Practice Address - Fax:787-738-1860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJA CAYEY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12060208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG61338Medicare UPIN