Individual
DR. PAUL JAI THERATTIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 W ESSEX ST STE 202, MAYWOOD, NJ 07607-1023
(973) 972-8092
(201) 603-1993
Mailing address
211 WOODBINE CIR, NEW PROVIDENCE, NJ 07974-1737
(201) 603-1993
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
25MA10358100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2013
Last updated
06/20/2024
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