Provider Demographics
NPI:1922105451
Name:JAY MEDICAL & REHAB WORKS PC
Entity Type:Organization
Organization Name:JAY MEDICAL & REHAB WORKS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARIANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-714-8522
Mailing Address - Street 1:3457 LAWRENCEVILLE SUWANEE RD STE C
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6426
Mailing Address - Country:US
Mailing Address - Phone:678-714-8522
Mailing Address - Fax:678-714-8542
Practice Address - Street 1:3457 LAWRENCEVILLE SUWANEE RD STE C
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6426
Practice Address - Country:US
Practice Address - Phone:678-714-8522
Practice Address - Fax:678-714-8542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49861207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00083235/000684978LMedicaid
GA11BDWLNMedicare ID - Type Unspecified
GAH10875Medicare UPIN