Individual
DR. JESSICA ANJALI GEETA GANGARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-2647
(585) 275-0707
Mailing address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-2647
(585) 275-0707
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
300950
NY
2080P0206X
Pediatric Gastroenterology Physician
Primary
300950
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300950
STATE LICENSE
NY
Enumeration date
06/11/2013
Last updated
07/03/2023
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