| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KANISHQ RAJAN JETHANI | 1003553744 | 2023-01-24 |
Kanishq Rajan Jethani is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1003553744. Registration indicates Kanishq Rajan Jethani is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Mr. Kanishq Rajan Jethani M.D |
| Practice Office Address | 501 S. WASHINGTON AVE. SCRANTON, PA US |
| Practice Office Telephone | 5708663058 |
| Mailing Address | THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION 501 S. WASHINGTON AVE., SUITE 1000 SCRANTON, PA 18505 US |
| Business Telephone | 5708663058 |
| Business Fax | 5703434800 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |