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General NPI Number Information
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NPI Number | 1790779551
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Entity Type | Individual
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Provider Name | JIFFY SETO MD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 5801 ARMY PENTAGON
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City | WASHINGTON
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State | DC
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Zip | 20310-5023
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Country | US
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Telephone | 703-692-8908
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Fax | 703-692-8561
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Provider Business Mailing Address
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Address Line | 3801 ARMY PENTAGON
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City | WASHINGTON
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State | DC
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Zip | 20310-0001
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Country | US
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Telephone | 703-692-8908
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101234521
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License Number State | VA
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