Mikszewski, Jerold
Mikszewski, Jerold is an individual health care provider with primary practice located at 3400 Spruce St 2 Ravdin, Philadelphia PA 19104-4238. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Mikszewski, Jerold can be contacted via phone (215) 662-3606.Contact Information
Primary practice address
3400 Spruce St 2 Ravdin
Philadelphia PA 19104-4238
Phone: (215) 662-3606
Fax: (215) 349-5579
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 0101030137 | Virginia |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD021941E | Pennsylvania |
Profile Details
| NPI number | 1215927736 |
|---|---|
| LBN Legal business name | Mikszewski, Jerold |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Aug 26th, 2016 - about 10 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 | 1215927736 | NPPES |
| Virginia | MEDICAID | 6150560 |
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