Provider Demographics
NPI:1821010265
Name:WARRIER, JAYA S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYA
Middle Name:S
Last Name:WARRIER
Suffix:
Gender:F
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:PO BOX 2490
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70073-2490
Mailing Address - Country:US
Mailing Address - Phone:504-762-8900
Mailing Address - Fax:504-328-0899
Practice Address - Street 1:1855 AMES BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3429
Practice Address - Country:US
Practice Address - Phone:504-762-8900
Practice Address - Fax:504-328-0899
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06133R207Q00000X
LA562439708261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1656810Medicaid
5W065Medicare PIN
G01746Medicare UPIN