Provider Demographics
NPI:1992973515
Name:N&I JANAS MEDICAL, P.C.
Entity type:Organization
Organization Name:N&I JANAS MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NODAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JANAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-643-2513
Mailing Address - Street 1:3501 202ND ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1117
Mailing Address - Country:US
Mailing Address - Phone:516-643-2513
Mailing Address - Fax:718-679-9150
Practice Address - Street 1:3501 202ND ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1117
Practice Address - Country:US
Practice Address - Phone:516-643-2513
Practice Address - Fax:718-679-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY226527OtherLICENSE
NYWEZ101Medicare PIN
NY5572B1Medicare PIN