Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 35-085017 | OH |
NPI | 1083630131 |
---|---|
Provider Name | Marta Jakubowycz |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 29/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000224418 | UNISON (01) | OH |
000000539569 | ANTHEM (01) | OH |
2546301 | (05) | OH |
363665 | WELLCARE (01) | OH |
745497 | BUCKEYE (01) | OH |
7769682 | AETNA (01) | OH |
I27639 | (02) | |
P00230694 | RAILROAD MEDICARE (01) | OH |