Individual
MR. KANISHQ RAJAN JETHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01107-1619
(413) 794-4320
(413) 794-1767
Mailing address
280 CHESTNUT ST FL 2, SPRINGFIELD, MA 01199-1001
(413) 794-3909
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1023396
MA
208M00000X
Hospitalist Physician
1023396
MA
Other
Enumeration date
05/15/2022
Last updated
09/10/2025
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