Provider Demographics
NPI:1811204522
Name:J J& JAY PROVIDES
Entity Type:Organization
Organization Name:J J& JAY PROVIDES
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOME HEALTH AIDE,ILST,HCSS
Authorized Official - Prefix:MISS
Authorized Official - First Name:NDARIA
Authorized Official - Middle Name:EUMND
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-399-3586
Mailing Address - Street 1:133 DIDAMA ST
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1545
Mailing Address - Country:US
Mailing Address - Phone:315-399-3586
Mailing Address - Fax:
Practice Address - Street 1:133 DIDAMA ST
Practice Address - Street 2:2 FLOOR
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1545
Practice Address - Country:US
Practice Address - Phone:315-399-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health