Provider Demographics
NPI:1861623019
Name:RATHEE, JYOTSNA (MD)
Entity type:Individual
Prefix:DR
First Name:JYOTSNA
Middle Name:
Last Name:RATHEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6744 N INVERGORDON RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4219
Mailing Address - Country:US
Mailing Address - Phone:623-377-8743
Mailing Address - Fax:
Practice Address - Street 1:6744 N INVERGORDON RD
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-4219
Practice Address - Country:US
Practice Address - Phone:623-377-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR70449207R00000X
AZ44865208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ148015Medicare PIN