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Ketevan Jorjadze

NPI Registration Record

Provider / OrganizationNPIDate Certified
KETEVAN JORJADZE13367378402021-01-10
Entity TypeIndividual
Provider Name Ketevan Jorjadze
Practice Office Address24 ROBINSON ST
SHOREHAM, NY US
Practice Office Telephone6319057515
Mailing Address24 ROBINSON ST
SHOREHAM, NY 117862128 US
Business Telephone6319057515
HPT Codes
CodeLicense NoState
363LF0000X PRIMARYF346697 NY
OPI Codes
F346697 OTHER NY NYS

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