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General NPI Number Information
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NPI Number | 1417218512
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTH CONSULTANTS INC
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 2620 MINERAL SPRINGS AVE SUITE A
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City | KNOXVILLE
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State | TN
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Zip | 37917-1569
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Country | US
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Telephone | 865-219-6968
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Fax | 865-219-8636
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Provider Business Mailing Address
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Address Line | 2620 MINERAL SPRINGS AVE SUITE A
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City | KNOXVILLE
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State | TN
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Zip | 37917-1569
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Country | US
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Telephone | 865-219-6968
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Fax | 865-219-8636
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Authorized Official
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Title or Position | SOLE EMPLOYEE
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Name | DR. VIJAY JETHANANDANI
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Credential | PRESIDENT
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Telephone | 865-219-6968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 019665
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 019665
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License Number State | TN
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