Provider Demographics
NPI:1770678021
Name:JANAS, NODAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NODAR
Middle Name:
Last Name:JANAS
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 1:20 WESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1823
Mailing Address - Country:US
Mailing Address - Phone:516-643-2513
Mailing Address - Fax:718-679-9150
Practice Address - Street 1:3501 202ND ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1117
Practice Address - Country:US
Practice Address - Phone:718-224-7194
Practice Address - Fax:718-679-9150
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine