Provider Demographics
NPI:1386673671
Name:JANI, NIRAJ (MD)
Entity type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:
Last Name:JANI
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 1:1515 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-645-3499
Mailing Address - Fax:302-644-4830
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:PPE, SUITE 512
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:410-601-5392
Practice Address - Fax:410-601-5757
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25IA12525200207RG0100X
PAMD428156207RG0100X
DEC1-0027798207RG0100X
MDD65668207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014273500Medicaid
MDC31152OtherR/R MEDICARE GROUP PIN
MDC31152OtherR/R MEDICARE GROUP PIN
MDS583Q723Medicare PIN
MDI55755Medicare UPIN