1134391022 NPI number — MRS. MARIA ERNESTINA JASINSKAS M.D.

Table of content: MRS. MARIA ERNESTINA JASINSKAS M.D. (NPI 1134391022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134391022 NPI number — MRS. MARIA ERNESTINA JASINSKAS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JASINSKAS
Provider First Name:
MARIA
Provider Middle Name:
ERNESTINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VEGA
Provider Other First Name:
MARIA
Provider Other Middle Name:
ERNESTINA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1134391022
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GOD-CENTERED PSYCHIATRIC CARE, LLC
Provider Second Line Business Mailing Address:
10 WESTBURY PARK WAY, STE C2
Provider Business Mailing Address City Name:
BLUFFTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29910-8864
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-867-3873
Provider Business Mailing Address Fax Number:
843-867-3876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GOD-CENTERED PSYCHIATRIC CARE, LLC
Provider Second Line Business Practice Location Address:
10 WESTBURY PARK WAY, STE C2
Provider Business Practice Location Address City Name:
BLUFFTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29910-8864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-867-3873
Provider Business Practice Location Address Fax Number:
843-867-3876
Provider Enumeration Date:
03/31/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  MD86639 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)