Provider Demographics
NPI:1184238560
Name:JCY INTERNAL MEDICINE PSC
Entity type:Organization
Organization Name:JCY INTERNAL MEDICINE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-313-4182
Mailing Address - Street 1:P.O. BOX 1179
Mailing Address - Street 2:
Mailing Address - City:SABARIA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1179
Mailing Address - Country:US
Mailing Address - Phone:787-804-0399
Mailing Address - Fax:787-808-5069
Practice Address - Street 1:CALLE ANGEL MARTINEZ ESQ. SAN ISIDRO 25 B
Practice Address - Street 2:
Practice Address - City:SABARIA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-804-0399
Practice Address - Fax:787-808-5069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty