Individual provider Active NPI

Janet Diane Pandori, LMSW

  • Social Worker
  • Manlius, NY
National Provider Identifier
1689811754
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
033576-1 Issued in NY
Practice address
4945 Fayetteville Manlius Rd
Manlius, NY 13104-1006
Phone
(315) 682-1063
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 033576-1 NY Primary

Addresses

Primary practice location

4945 Fayetteville Manlius Rd
Manlius, NY 13104-1006

Mailing address

4945 Fayetteville Manlius Rd
Manlius, NY 13104-1006
Phone (315) 682-1063

Other identifiers 1

IdentifierTypeStateIssuer
033576-1OtherNYTHE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
033576-1NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1689811754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4945 FAYETTEVILLE MANLIUS RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041006",
            "telephone_number": "315-682-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 FAYETTEVILLE MANLIUS RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041006",
            "telephone_number": "315-682-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDORI",
        "first_name": "JANET",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "033576-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT",
            "identifier": "033576-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.