MEDICARE: RICHARD M JAY D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	001155	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649277583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD M JAY D.P.M.

Provider Business Mailing Address
First Line	:	994 W SHERMAN AVE
Second Line	:	BLDG 1
City	:	VINELAND
State	:	NJ
Zip	:	08360-6937
Country	:	US
Telephone Number	:	856-696-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	994 W SHERMAN AVE
Second Line	:	BLDG 1
City	:	VINELAND
State	:	NJ
Zip	:	08360-6937
Country	:	US
Telephone Number	:	856-696-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	04/04/2014

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