Individual
MR. GYAN CHETAN MOORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBE
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF GENERAL PEDIATRICS, PHILADELPHIA, PA 19104-4319
(915) 222-1513
Mailing address
104 CAMINO PENASCO, EL PASO, TX 79912-3438
(915) 222-1513
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MT234481
PA
Other
Enumeration date
03/25/2025
Last updated
06/11/2025
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