Provider Demographics
NPI:1366515579
Name:JANARDHAN, HALDIPUR V (MD)
Entity type:Individual
Prefix:
First Name:HALDIPUR
Middle Name:V
Last Name:JANARDHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 PORTLAND AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2730
Mailing Address - Country:US
Mailing Address - Phone:585-467-0822
Mailing Address - Fax:585-467-0003
Practice Address - Street 1:1299 PORTLAND AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2730
Practice Address - Country:US
Practice Address - Phone:585-467-0822
Practice Address - Fax:585-467-0003
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108195207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY102163CKOtherPREFERRED CARE
NY6811OtherBS
NY6811OtherBS