Provider Demographics
NPI:1205046349
Name:DRELINGER, JAY S
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:S
Last Name:DRELINGER
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 1:5060 SUNRISE BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4944
Mailing Address - Country:US
Mailing Address - Phone:916-863-1404
Mailing Address - Fax:916-863-7384
Practice Address - Street 1:5060 SUNRISE BLVD STE A1
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4944
Practice Address - Country:US
Practice Address - Phone:916-863-1404
Practice Address - Fax:916-863-7384
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2959332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment