=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659470219
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE R BAJAKIAN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2006
-----------------------------------------------------
Last Update Date | 09/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 161 FT WASHINGTN AVE FL 5 COLUMBIA UNIVERSITY- DEPT OF SURGEY
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10032-3729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-932-5169
-----------------------------------------------------
Fax | 212-932-5468
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 27036 COLUMBIA UNIV.
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10087-7036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-932-5169
-----------------------------------------------------
Fax | 212-932-5468
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 209998
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------