Provider Demographics
NPI:1215627286
Name:JAYSWAL, AMAR
Entity type:Individual
Prefix:
First Name:AMAR
Middle Name:
Last Name:JAYSWAL
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 1:121 DEKALB AVENUE, BROOKLYN
Mailing Address - Street 2:THE BROOKLYN HOSPITAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-250-6604
Mailing Address - Fax:
Practice Address - Street 1:121 DEKALB AVENUE, BROOKLYN
Practice Address - Street 2:THE BROOKLYN HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program