Provider Demographics
NPI:1851318414
Name:J & Y MED SERV INC
Entity type:Organization
Organization Name:J & Y MED SERV INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:V
Authorized Official - Last Name:RIVERA IRZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-839-6775
Mailing Address - Street 1:PO BOX 1837
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1837
Mailing Address - Country:US
Mailing Address - Phone:787-839-6775
Mailing Address - Fax:787-839-6775
Practice Address - Street 1:25 CALLE GENERAL BROOKE APT 1
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-2640
Practice Address - Country:US
Practice Address - Phone:787-839-6775
Practice Address - Fax:787-839-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10981208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400232OtherMMM HEALTCARE
PR2701AOtherPREFERRED MEDICARE CHOICE