Provider Demographics
NPI:1740531979
Name:JANCO, JANA (MD)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:JANCO
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 1:16 SOMMERSET DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-6713
Mailing Address - Country:US
Mailing Address - Phone:917-257-4314
Mailing Address - Fax:
Practice Address - Street 1:16 SOMMERSET DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-6713
Practice Address - Country:US
Practice Address - Phone:917-257-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09175400207L00000X
CT70505207L00000X
NY267258207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology