Provider Demographics
NPI:1811395437
Name:JANI, MAHESHWAR CHANDRAHAS (PA)
Entity Type:Individual
Prefix:MR
First Name:MAHESHWAR
Middle Name:CHANDRAHAS
Last Name:JANI
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-638-4170
Mailing Address - Fax:631-638-4170
Practice Address - Street 1:HSC T16 080
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8167
Practice Address - Country:US
Practice Address - Phone:631-444-1060
Practice Address - Fax:631-444-1054
Is Sole Proprietor?:No
Enumeration Date:2014-12-13
Last Update Date:2022-12-09
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Provider Licenses
StateLicense IDTaxonomies
NY018278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant