Provider Demographics
NPI:1659916880
Name:PANDIT, JAIDEEP JAGDEESH
Entity Type:Individual
Prefix:
First Name:JAIDEEP
Middle Name:JAGDEESH
Last Name:PANDIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O SUSAN KILBRIDE, DEPT OF ANESTHESIA
Mailing Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTRE, 330 BROOKLINE AVE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-3110
Mailing Address - Fax:
Practice Address - Street 1:C/O SUSAN KILBRIDE, DEPT OF ANESTHESIA
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTRE, 330 BROOKLINE AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program