Basic Information
| Provider Information | |||||||||
| NPI: | 1548222557 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JANI | ||||||||
| FirstName: | BINOY | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2010 BREMO RD STE 128A | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232262444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8779690392 | ||||||||
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| Practice Location | |||||||||
| Address1: | 927 MAPLE GROVE DR STE 209 | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224076936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402085827 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 03/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 010123124 | VA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 0101231244 | VA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 010218021 | 05 | VA | MEDICAID |