Individual
JAYA B GANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
GENETICS & GENOMIC SCIENCES, 1 GUSTAVE LEVY L. PLACE #1497, NEW YORK, NY 10029-6500
(212) 241-6947
(212) 860-3316
Mailing address
1 GUSTAVE L LEVY PL # 1497, NEW YORK, NY 10029-6504
(212) 241-6947
(212) 860-3315
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD417029
PA
207SG0202X
Clinical Biochemical Genetics Physician
MD417029
PA
208000000X
Pediatrics Physician
MD417029
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015857
—
NJ
05
—
100841117
—
PA
01
—
8J8241
EBCBS
NY
Enumeration date
07/24/2006
Last updated
03/25/2019
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