MEDICARE: DR. SHRADDHA DEVENDRA JANI 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
1	2084P0800X	Psychiatry Physician	MT193584	PA

General Provider Information

NPI Number	:	1932363272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHRADDHA DEVENDRA JANI M.D.

Provider Business Mailing Address
First Line	:	1518 WALNUT STREET
Second Line	:	SUITE 1202
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130
Country	:	US
Telephone Number	:	610-780-1690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 WALNUT STREET
Second Line	:	SUITE 1202
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130
Country	:	US
Telephone Number	:	610-780-1690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/21/2022

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