Most Relevant Information
Provider Data
| NPI Number: | 1003553744 |
| Provider Name: | KANISHQ RAJAN JETHANI M.D |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/15/2022 |
| Last Updated: | 01/24/2023 |
Provider Practice Location
501 S. WASHINGTON AVE.
SCRANTON
PA
18505
Practice Location Phone/Fax
| Phone: | 5708663058 |
| Fax: |
Provider Mailing Location
THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION
501 S. WASHINGTON AVE., SUITE 1000
SCRANTON
PA
18505
Provider Mailing Phone/Fax
| Phone: | 5708663058 |
| Fax: | 5703434800 |