Individual
DR. JENY M. POTHEN ITTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
500 W THOMAS RD STE 900A, PHOENIX, AZ 85013-4223
(602) 406-3540
(602) 406-7186
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
005304
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
455059
—
AZ
Enumeration date
07/02/2008
Last updated
12/16/2024
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