Healthcare Provider Details

I. General information

NPI: 1598445280
Provider Name (Legal Business Name): ADARSH KUMAR JHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

4415 CRICKET RIDGE DR APT 201
HOLT MI
48842-2951
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-1600
  • Fax:
Mailing address:
  • Phone: 517-648-6156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4351051374
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: