Provider Demographics
NPI:1477536860
Name:SENDAK, JANICE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:
Last Name:SENDAK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:STE 100A
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8520
Mailing Address - Country:US
Mailing Address - Phone:410-819-0710
Mailing Address - Fax:410-819-0712
Practice Address - Street 1:515 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-296-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR079151207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD020701200Medicaid
MDJ057Medicare ID - Type Unspecified
MDR09170Medicare UPIN