Provider Demographics
NPI:1114776796
Name:JANGA, LAKSHMI SAI NIHARIKA (MD)
Entity type:Individual
Prefix:
First Name:LAKSHMI SAI NIHARIKA
Middle Name:
Last Name:JANGA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MOUNT AUBURN STREET
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-499-5571
Mailing Address - Fax:617-499-5593
Practice Address - Street 1:330 MOUNT AUBURN STREET
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-499-5571
Practice Address - Fax:617-499-5593
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2025-04-29
Deactivation Date:2025-01-10
Deactivation Code:
Reactivation Date:2025-04-29
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program