Provider Demographics
NPI:1821279084
Name:JANI, AJAY NARENDRA (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:NARENDRA
Last Name:JANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AJAYKUMAR
Other - Middle Name:NARENDRA
Other - Last Name:JANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:838 PENN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-1108
Mailing Address - Country:US
Mailing Address - Phone:610-988-4838
Mailing Address - Fax:
Practice Address - Street 1:838 PENN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1108
Practice Address - Country:US
Practice Address - Phone:610-988-4838
Practice Address - Fax:610-288-4515
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433011207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102117023Medicaid
PA102117023Medicaid