Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 25MA09633500 | NJ |
NPI | 1083857858 |
---|---|
Provider Name | Reena Natwarlal Jethva |
First Address | Hackensack, NJ 07601-1915 |
Second Address | Philadelphia, PA 19134-1095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2009 |
Last Update Date | 24/05/2017 |