Provider Demographics
NPI:1306074935
Name:GERMANO, JANE (DO)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:GERMANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 VARNUM ST NE
Mailing Address - Street 2:DEPT OF PEDIATRICS
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2104
Mailing Address - Country:US
Mailing Address - Phone:202-854-7074
Mailing Address - Fax:202-854-7470
Practice Address - Street 1:1150 VARNUM ST NE
Practice Address - Street 2:DEPT OF PEDIATRICS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2104
Practice Address - Country:US
Practice Address - Phone:202-854-7074
Practice Address - Fax:202-854-7470
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034479208000000X
390200000X
NY267085208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program