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General NPI Number Information
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NPI Number | 1326015587
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Entity Type | Individual
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Provider Name | JESSIE GANJOO MD
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Gender | Female
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 765 LIBERTY ST STE 307A
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City | MEADVILLE
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State | PA
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Zip | 16335-2566
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Country | US
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Telephone | 814-333-3945
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Fax | 814-333-3947
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Provider Business Mailing Address
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Address Line | 704 N MAIN ST
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City | MEADVILLE
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State | PA
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Zip | 16335-1955
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Country | US
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Telephone | 724-877-2214
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD426877
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License Number State | PA
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