Healthcare Provider Details

I. General information

NPI: 1366515579
Provider Name (Legal Business Name): HALDIPUR V. JANARDHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 PORTLAND AVE SUITE 7
ROCHESTER NY
14621-2730
US

IV. Provider business mailing address

1299 PORTLAND AVE SUITE 7
ROCHESTER NY
14621-2730
US

V. Phone/Fax

Practice location:
  • Phone: 585-467-0822
  • Fax: 585-467-0003
Mailing address:
  • Phone: 585-467-0822
  • Fax: 585-467-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number108195
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: