Provider Demographics
NPI:1700414299
Name:STARAVECKA, JANIE (DPM)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:STARAVECKA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 N HIGH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8915
Mailing Address - Country:US
Mailing Address - Phone:614-741-4001
Mailing Address - Fax:
Practice Address - Street 1:68 N HIGH ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8915
Practice Address - Country:US
Practice Address - Phone:614-741-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.004178213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty