Individual
DR. SAMIR C. JETHWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4752
Mailing address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4752
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MB09398100
NJ
2085R0202X
Diagnostic Radiology Physician
2769431
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MB09398100
NJ
2085R0204X
Vascular & Interventional Radiology Physician
2769431
NY
Other
Enumeration date
04/16/2009
Last updated
12/01/2016
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