Provider Demographics
NPI:1225079569
Name:JANADRI, BCHARA (MD)
Entity Type:Individual
Prefix:DR
First Name:BCHARA
Middle Name:
Last Name:JANADRI
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 1:2618 C MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425
Mailing Address - Country:US
Mailing Address - Phone:724-628-9303
Mailing Address - Fax:724-682-3297
Practice Address - Street 1:2618 C MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1419
Practice Address - Country:US
Practice Address - Phone:724-628-9303
Practice Address - Fax:724-628-3297
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049245-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101402OtherUPMC HEALTH PLAN
PAP001407OtherGATEWAY HEALTH PLAN
PA876903OtherHIGHMARK MEDICARE SERVICE
PA000000060550OtherUNISON HEALTH PLAN
PAMD049245-LOtherSTATE LICENSE
PA0662370000OtherINDEPENDENCE BLUE SHIELD
PA0014236920004Medicaid
PA062003OtherHIGHMARK BLUE SHIELD
PA224943OtherHEALTH AMERICA
PAF61646Medicare UPIN