Healthcare Provider Details

I. General information

NPI: 1659470219
Provider Name (Legal Business Name): DANIELLE R BAJAKIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FT WASHINGTN AVE FL 5 COLUMBIA UNIVERSITY- DEPT OF SURGEY
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

PO BOX 27036 COLUMBIA UNIV.
NEW YORK NY
10087-7036
US

V. Phone/Fax

Practice location:
  • Phone: 212-932-5169
  • Fax: 212-932-5468
Mailing address:
  • Phone: 212-932-5169
  • Fax: 212-932-5468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number209998
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: