Provider Demographics
NPI:1003644329
Name:NELLIPARAMBIL JITHEESH, ASHWIN
Entity type:Individual
Prefix:
First Name:ASHWIN
Middle Name:
Last Name:NELLIPARAMBIL JITHEESH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BOULEVARD
Mailing Address - Street 2:ST. MARY'S HOSPITAL MEMORIAL BUILDING, ROOM 416
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 BOULEVARD
Practice Address - Street 2:ST. MARY'S HOSPITAL MEMORIAL BUILDING, ROOM 416
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2840
Practice Address - Country:US
Practice Address - Phone:404-503-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program