Individual
AJAY V. JETLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 ACKERMAN AVE, CLIFTON, NJ 07011-1501
(973) 928-2880
(973) 928-2881
Mailing address
46 UNION AVE, CRESSKILL, NJ 07626-2125
(201) 399-7695
(201) 399-7697
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35096587
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA09223700
MEDICAL LICENSE
NJ
Enumeration date
05/27/2009
Last updated
10/12/2021
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