Provider Demographics
NPI:1467744672
Name:JANOWSKI, EINSLEY-MARIE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:EINSLEY-MARIE
Middle Name:
Last Name:JANOWSKI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:EINSLEY
Other - Middle Name:
Other - Last Name:JANOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1240 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0817
Practice Address - Country:US
Practice Address - Phone:434-924-5191
Practice Address - Fax:434-982-3262
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA01012606452085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program