MEDICARE: DR. SUSHMA N JANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	D35786	MD

General Provider Information

NPI Number	:	1225095714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSHMA N JANI MD

Provider Business Mailing Address
First Line	:	10810 HICKORY RIDGE RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3622
Country	:	US
Telephone Number	:	410-997-5500
Fax Number	:	410-992-7553

Provider Business Practice Location Address
First Line	:	HAWTHORNE OFFICE PARK
Second Line	:	10810 HICKORY RIDGE ROAD
City	:	COLUMBIA
State	:	MD
Zip	:	21044
Country	:	US
Telephone Number	:	410-997-5500
Fax Number	:	410-992-7553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	04/16/2026

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