Provider Demographics
NPI:1790779551
Name:SETO, JIFFY (MD)
Entity Type:Individual
Prefix:DR
First Name:JIFFY
Middle Name:
Last Name:SETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 ARMY PENTAGON
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20310-0001
Mailing Address - Country:US
Mailing Address - Phone:703-692-8908
Mailing Address - Fax:
Practice Address - Street 1:5801 ARMY PENTAGON
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-5023
Practice Address - Country:US
Practice Address - Phone:703-692-8908
Practice Address - Fax:703-692-8561
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine