Jesudasan, Ajantha
Jesudasan, Ajantha is an individual health care provider with primary practice located at 1425 Portland Ave , Rochester NY 14621. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Jesudasan, Ajantha can be contacted via phone (585) 922-5067.Contact Information
Primary practice address
1425 Portland Ave
Rochester NY 14621
Phone: (585) 922-5067
Fax: (585) 922-2908
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 299505 | New York |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 299505 | New York |
Profile Details
| NPI number | 1780060012 |
|---|---|
| LBN Legal business name | Jesudasan, Ajantha |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2015 |
| Last updated | Jul 12th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780060012 | NPPES |
| New York | Other | 14496499 | CAQH |
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