Provider Demographics
NPI:1306191994
Name:CHETA, JORDANA NOREEN (MD)
Entity type:Individual
Prefix:
First Name:JORDANA
Middle Name:NOREEN
Last Name:CHETA
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 1:286 ELDER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-5011
Mailing Address - Country:US
Mailing Address - Phone:702-504-0283
Mailing Address - Fax:702-483-6202
Practice Address - Street 1:2500 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0482
Practice Address - Country:US
Practice Address - Phone:702-333-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257972207RC0200X
NV17559207RN0300X, 207RC0200X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program