Provider Demographics
NPI:1821221896
Name:LUMAGUE, JAYSON UYLENGCO
Entity Type:Individual
Prefix:MR
First Name:JAYSON
Middle Name:UYLENGCO
Last Name:LUMAGUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 VIRGINIA AVE APT 42
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1457
Mailing Address - Country:US
Mailing Address - Phone:646-894-2490
Mailing Address - Fax:
Practice Address - Street 1:7 EDGEMONT CIR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-2615
Practice Address - Country:US
Practice Address - Phone:646-894-2490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY608755163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse