Provider Demographics
NPI:1194901025
Name:JAYASINHA, YASANGI MARINA (MD)
Entity type:Individual
Prefix:DR
First Name:YASANGI
Middle Name:MARINA
Last Name:JAYASINHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HIGHWAY K
Mailing Address - Street 2:SUITE 4
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-8423
Mailing Address - Country:US
Mailing Address - Phone:636-240-9896
Mailing Address - Fax:
Practice Address - Street 1:1001 HIGHWAY K
Practice Address - Street 2:SUITE 4
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-8423
Practice Address - Country:US
Practice Address - Phone:636-240-9896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007002167208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics