Healthcare Provider Details

I. General information

NPI: 1841286689
Provider Name (Legal Business Name): JAY ALAN OCUIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 418
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW STE 418
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-882-2500
  • Fax: 202-726-8076
Mailing address:
  • Phone: 202-882-2500
  • Fax: 202-726-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD9363
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: