Basic Information
| Provider Information | |||||||||
| NPI: | 1609863745 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GROVER | ||||||||
| FirstName: | JYOTISH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 118 N BEDFORD RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105492553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146668866 | ||||||||
| FaxNumber: | 9146666777 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 HIGHLAND AVE | ||||||||
| Address2: | LEWISTOWN HOSPITAL | ||||||||
| City: | LEWISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170441167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172427121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2005 | ||||||||
| LastUpdateDate: | 08/13/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | MD071002L | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208VP0014X | MD071002L | PA | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01803261 | 05 | PA | MEDICAID |