Provider Demographics
NPI:1760655468
Name:JANANIA, JAMAL CAMILO (MD)
Entity Type:Individual
Prefix:
First Name:JAMAL
Middle Name:CAMILO
Last Name:JANANIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14789 ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NY
Mailing Address - Zip Code:14411-9709
Mailing Address - Country:US
Mailing Address - Phone:585-589-2273
Mailing Address - Fax:585-589-1876
Practice Address - Street 1:14789 ROUTE 31
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-9709
Practice Address - Country:US
Practice Address - Phone:585-589-2273
Practice Address - Fax:585-589-1876
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101159174400000X
NY255326-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist