Individual provider Active NPI

Adeel A Janjua I, OWNER

  • Contractor
  • Albany, NY
National Provider Identifier
1912456534
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
81-1354556 Issued in NY
Practice address
17 Roosevelt St
Albany, NY 12206
Phone
(518) 764-5163
NPI assigned
Sep 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 81-1354556 NY Primary

Addresses

Primary practice location

17 Roosevelt St
Albany, NY 12206

Mailing address

17 Roosevelt St
Albany, NY 12206-1407
Phone (518) 764-5163

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
81-1354556NYMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1912456534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ROOSEVELT ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061407",
            "telephone_number": "518-764-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ROOSEVELT ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12206",
            "telephone_number": "518-764-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANJUA",
        "first_name": "ADEEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "OWNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "81-1354556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.