Cichocki, Jonathan J
Cichocki, Jonathan J is an sole proprietor health care provider with primary practice located at 818 W Terrell Ave , Fort Worth TX 76104-3133. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Cichocki, Jonathan J can be contacted via phone (817) 335-1875.Contact Information
Primary practice address
818 W Terrell Ave
Fort Worth TX 76104-3133
Phone: (817) 335-1875
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G0609 | Texas |
Profile Details
| NPI number | 1861476376 |
|---|---|
| LBN Legal business name | Cichocki, Jonathan J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Apr 25th, 2008 - about 18 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 | 1861476376 | NPPES |
| Texas | MEDICAID | 0352239-01 | |
| Texas | Other | 826183519 |
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