Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 27611 | MS |
NPI | 1144667122 |
---|---|
Provider Name | Vandana Janaki Vedanarayanan |
First Address | Jackson, MS 39216-4500 |
Second Address | Buffalo, NY 14214-3001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2013 |
Last Update Date | 15/09/2020 |