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NPI Code Detail

MEDICARE: JANINA PRZYSTAL M.D.

MEDICARE: JANINA PRZYSTAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician126167NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000507440001OTHERNYBLUE CROSS
2040426001462OTHERNYFIDELIS
300020067903OTHERNYUNIVERA
42009997OTHERNYINDEPENDENT HEALTH
54284OTHERGHI
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275593303
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANINA PRZYSTAL M.D.
Provider Business Mailing Address
First Line : 604 ALT BLVD
Second Line :
City : GRAND ISLAND
State : NY
Zip : 14072-2450
Country : US
Telephone Number : 716-773-2059
Fax Number :
Provider Business Practice Location Address
First Line : 2605 HARLEM RD
Second Line :
City : CHEEKTOWAGA
State : NY
Zip : 14225-4018
Country : US
Telephone Number : 716-891-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 08/24/2007

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