Provider Demographics
NPI:1528493616
Name:CAGE, JAY
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:
Last Name:CAGE
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 1:1920 COBDEN RD
Mailing Address - Street 2:
Mailing Address - City:LAVEROCK
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7222
Mailing Address - Country:US
Mailing Address - Phone:267-236-2643
Mailing Address - Fax:
Practice Address - Street 1:1920 COBDEN RD
Practice Address - Street 2:
Practice Address - City:LAVEROCK
Practice Address - State:PA
Practice Address - Zip Code:19038-7222
Practice Address - Country:US
Practice Address - Phone:267-236-2643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health