Healthcare Provider Details

I. General information

NPI: 1699752550
Provider Name (Legal Business Name): DANIEL D JANIAK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WALSH RD CRAFTON-INGRAM SHOPPING CENTER
PITTSBURGH PA
15205-2336
US

IV. Provider business mailing address

1 WALSH RD CRAFTON-INGRAM SHOPPING CENTER
PITTSBURGH PA
15205-2336
US

V. Phone/Fax

Practice location:
  • Phone: 412-922-3773
  • Fax: 412-922-6093
Mailing address:
  • Phone: 412-922-3773
  • Fax: 412-922-6093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS003284L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS003284L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: