Healthcare Provider Details

I. General information

NPI: 1376371583
Provider Name (Legal Business Name): JASLIN ORELUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARGINAL CARR # 2, KM 47.7
MANATI PR
00674
US

IV. Provider business mailing address

5 WILLOW BROOK LN
WESTFIELD MA
01085-1579
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3322
  • Fax:
Mailing address:
  • Phone: 781-219-8988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number17153-I
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: