Provider Demographics
NPI:1669890141
Name:TRYJANKOWSKI, JANELLE MARIE (MD)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARIE
Last Name:TRYJANKOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3560
Mailing Address - Country:US
Mailing Address - Phone:716-208-5058
Mailing Address - Fax:
Practice Address - Street 1:134 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:716-208-5058
Practice Address - Fax:757-473-0075
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264797207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program