1386946176 NPI number — INAYA PSYCHIATRIC MEDICAL GROUP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386946176 NPI number — INAYA PSYCHIATRIC MEDICAL GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INAYA PSYCHIATRIC MEDICAL GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386946176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 251
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00986-0251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-850-4515
Provider Business Mailing Address Fax Number:
787-852-6202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VIA CUMBRES STREET URB LA VISTA
Provider Second Line Business Practice Location Address:
G 11
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-850-4515
Provider Business Practice Location Address Fax Number:
787-852-6202
Provider Enumeration Date:
11/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ RAMOS
Authorized Official First Name:
ISHNAR
Authorized Official Middle Name:
M
Authorized Official Title or Position:
COORPORATIVE PRESIDENT
Authorized Official Telephone Number:
787-249-4774

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  6613 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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