Provider Demographics
NPI:1881827467
Name:WITTGREEN-NEGRON, JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:
Last Name:WITTGREEN-NEGRON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:WITTGREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 79757
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9757
Mailing Address - Country:US
Mailing Address - Phone:787-421-3751
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO CECILIA'S PLACE - CALLE ROSA #7
Practice Address - Street 2:SUITE C-1 2DO PISO SUITE A
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-379-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty