Healthcare Provider Details

I. General information

NPI: 1558895011
Provider Name (Legal Business Name): RUCHA P JIYANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 BAY ROAD, UNIT B
DOVER DE
19901
US

IV. Provider business mailing address

640 S STATE ST # MC3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-9310
  • Fax: 302-744-9312
Mailing address:
  • Phone: 302-744-9310
  • Fax: 302-744-9312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC1-0029554
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: