Doctor Name: | DR. SAMIR C. JETHWA |
NPI Number: | 1871736108 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 25MB09398100 |
Business Practice Address: | 629d Lowther Rd Lewisberry, PA - 173399527 |
Business Phone Number: | 7179325200 |
Business Fax Number: | 7179323095 |
Mailing Address: | 450 Clarkson Ave, BROOKLYN |
State: | NY |
Postal Code: | 112032012 |
Phone Number: | 7182455137 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2009 |
NPI Last Update Date: | 04/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0204X |
License Number: | 25MB09398100 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Vascular & Interventional Radiology |
Taxonomy Definition: | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |