Individual
DR. VANYA JAITLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2109 S 48TH ST STE 102, TEMPE, AZ 85282-1018
(602) 685-5211
(602) 685-5325
Mailing address
PO BOX 42210, PHOENIX, AZ 85080-2210
(623) 266-7770
(623) 322-4639
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
63001
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
63001
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2016
Last updated
11/08/2021
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