Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 25MA08563000 | NJ |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD425445 | PA |
NPI | 1083669295 |
---|---|
Provider Name | Dr. Purvi Jitendra Jethva |
First Address | Philadelphia, PA 19107 |
Second Address | Langhorne, PA 19047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 19/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1021986940015 | (05) | PA |