Provider Demographics
NPI:1639251648
Name:PARDEE, JANE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:E
Last Name:PARDEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LINDEN OAKS SUITE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625
Mailing Address - Country:US
Mailing Address - Phone:585-381-4982
Mailing Address - Fax:585-381-1821
Practice Address - Street 1:220 LINDEN OAKS SUITE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625
Practice Address - Country:US
Practice Address - Phone:585-381-4982
Practice Address - Fax:585-381-1821
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228101208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02439641Medicaid
NY117604DLOtherPREFERRED CARE
NY7208509OtherAETNA
NY7208509OtherAETNA
NY02439641Medicaid