Provider Demographics
NPI:1316903586
Name:ALDRIDGE, JANERIO D (MD)
Entity type:Individual
Prefix:MR
First Name:JANERIO
Middle Name:D
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:100 HIGH ST # C3
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1126
Mailing Address - Country:US
Mailing Address - Phone:716-859-7600
Mailing Address - Fax:716-859-2885
Practice Address - Street 1:100 HIGH ST # C3
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-7600
Practice Address - Fax:716-859-2885
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY128093208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01100334Medicaid
NYJ400070096Medicare PIN
NYBB2278Medicare ID - Type Unspecified