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General NPI Number Information
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NPI Number | 1740202159
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Entity Type | Individual
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Provider Name | JAYA B GANESH M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | GENETICS & GENOMIC SCIENCES 1 GUSTAVE LEVY L. PLACE #1497
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City | NEW YORK
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State | NY
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Zip | 10029-6500
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Country | US
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Telephone | 212-241-6947
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Fax | 212-860-3316
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Provider Business Mailing Address
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Address Line | 1 GUSTAVE L LEVY PL # 1497
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City | NEW YORK
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State | NY
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Zip | 10029-6504
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Country | US
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Telephone | 212-241-6947
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Fax | 212-860-3315
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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 | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number | MD417029
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD417029
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | MD417029
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License Number State | PA
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