Provider Demographics
NPI:1710980958
Name:MORE, JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:
Last Name:MORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 ROUTE 22 E
Mailing Address - Street 2:STE 201
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1545
Mailing Address - Country:US
Mailing Address - Phone:732-302-1720
Mailing Address - Fax:732-302-1724
Practice Address - Street 1:1952 ROUTE 22 E
Practice Address - Street 2:STE 201
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1545
Practice Address - Country:US
Practice Address - Phone:732-302-1720
Practice Address - Fax:732-302-1724
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60547174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF55049Medicare UPIN
NJ180973Medicare ID - Type Unspecified