Healthcare Provider Details

I. General information

NPI: 1417467234
Provider Name (Legal Business Name): WILLIAM PATRICK JANES JR. PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 SYLVAN AVE STE 100
ENGLEWOOD CLIFFS NJ
07632-3308
US

IV. Provider business mailing address

106 MERCER ST APT 1
JERSEY CITY NJ
07302-3511
US

V. Phone/Fax

Practice location:
  • Phone: 201-569-2770
  • Fax:
Mailing address:
  • Phone: 401-835-2813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: