Individual
DR. JAIMALA THANIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
604 ELMWOOD AVENUE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-2141
(585) 244-7271
Mailing address
604 ELMWOOD AVENUE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-2141
(585) 244-7271
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
121860
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00362987
—
NY
01
—
010121860
BLUE CHOICE
NY
01
—
102222AH
PREFERRED CARE
NY
Enumeration date
04/14/2006
Last updated
09/10/2012
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