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General NPI Number Information
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NPI Number | 1023697620
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Entity Type | Individual
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Provider Name | BALAJI JAGDISH DO
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Gender | Male
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE
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City | ROCHESTER
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State | NY
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Zip | 14642-4772
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Country | US
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Telephone | 585-275-4711
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 FEDERAL ST STE B300
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City | PITTSBURGH
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State | PA
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Zip | 15212-4775
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Country | US
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Telephone | 412-359-3751
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS023984
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License Number State | PA
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