Provider Demographics
NPI:1568479970
Name:JINDAL, MEENU MITTAL (DO)
Entity Type:Individual
Prefix:DR
First Name:MEENU
Middle Name:MITTAL
Last Name:JINDAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 SYLVAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1335
Mailing Address - Country:US
Mailing Address - Phone:585-461-0254
Mailing Address - Fax:585-442-6580
Practice Address - Street 1:601 ELMWOOD AVE # 632B
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-2821
Practice Address - Fax:585-442-6580
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY245359208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program