Provider Demographics
NPI:1225095714
Name:JANI, SUSHMA N (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSHMA
Middle Name:N
Last Name:JANI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:HAWTHORNE OFFICE PARK
Mailing Address - Street 2:10810 HICKORY RIDGE ROAD
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:410-997-5500
Mailing Address - Fax:410-992-7553
Practice Address - Street 1:HAWTHORNE OFFICE PARK
Practice Address - Street 2:10810 HICKORY RIDGE ROAD
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:410-997-5500
Practice Address - Fax:410-992-7553
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
MDD357862084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
BJ0595833OtherDEA