Provider Demographics
NPI:1336870161
Name:JAISWAL, MANTHAN SUBHASHCHANDRA (MD)
Entity Type:Individual
Prefix:
First Name:MANTHAN
Middle Name:SUBHASHCHANDRA
Last Name:JAISWAL
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:NYC HEALTH HOSPITALS/METROPOLITAN
Mailing Address - Street 2:1901 FIRST AVENUE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-423-6271
Mailing Address - Fax:646-672-3034
Practice Address - Street 1:NYC HEALTH HOSPITALS/METROPOLITAN
Practice Address - Street 2:1901 FIRST AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6271
Practice Address - Fax:646-672-3034
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program