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NPI Code Detail

MEDICARE: DR. JANI ASSOCIATES, LLC

MEDICARE: DR. JANI ASSOCIATES, LLC
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
1251S00000XCommunity/Behavioral Health AgencyMD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619171535
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. JANI ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 426 DORCHESTER AVE
Second Line :
City : CAMBRIDGE
State : MD
Zip : 21613-2446
Country : US
Telephone Number : 410-228-3929
Fax Number : 410-228-3810
Provider Business Practice Location Address
First Line : 426 DORCHESTER AVE
Second Line :
City : CAMBRIDGE
State : MD
Zip : 21613-2446
Country : US
Telephone Number : 410-228-3929
Fax Number : 410-228-3810
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. STEPHANIE CAMPER
Credential :
Telephone Number : 410-334-6687
Provider Enumeration Date : 06/13/2007
Last Update Date : 01/14/2013

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Directions to “DR. JANI ASSOCIATES, LLC ” Practice Location

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