Provider Demographics
NPI:1770862682
Name:PAJAK, JANET E (LPN)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:E
Last Name:PAJAK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 296
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:NY
Mailing Address - Zip Code:14047-0296
Mailing Address - Country:US
Mailing Address - Phone:716-562-7012
Mailing Address - Fax:716-562-7109
Practice Address - Street 1:6816 ERIE ROAD
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:NY
Practice Address - Zip Code:14047
Practice Address - Country:US
Practice Address - Phone:716-562-7012
Practice Address - Fax:716-562-7109
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223511-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse