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General NPI Number Information
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NPI Number | 1245573302
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Entity Type | Individual
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Provider Name | BIREN KISHOR JUTHANI D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 447 PLAZA COURT BUILDING 500 SUITE B
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-1830
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Country | US
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Telephone | 570-426-2301
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Fax | 570-426-2306
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Provider Business Mailing Address
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Address Line | 440 PLAZA COURT BUILDING 500 SUITE B
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-8262
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Country | US
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Telephone | 570-426-2301
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Fax | 570-426-2306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | OS021122
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License Number State | PA
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