Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 210052 | NY |
NPI | 1073628244 |
---|---|
Provider Name | Dr. Mark Robert Jajkowski |
First Address | Buffalo, NY 14220-1700 |
Second Address | Cheektowaga, NY 14225-4021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 06/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00026371301 | UNIVERA (01) | NY |
000527369001 | BLUE CROSS/BLUE SHIELD (01) | NY |
010549324 | EMPIRE UNITED HEALTHCARE (01) | NY |
010549324 | GHI (01) | NY |
02414840 | (05) | NY |
040426002783 | FIDELIS (01) | NY |
1811716 | INDEPENDENT HEALTH (01) | NY |
H87602 | (02) |