Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 336600 | OR |
NPI | 1144614728 |
---|---|
Provider Name | Mr. Alexander Csajko |
First Address | Coos Bay, OR 97420-2045 |
Second Address | Coos Bay, OR 97420-2045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2015 |
Last Update Date | 01/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1407812365 | NORTH BEND MEDICAL CENTER GROUP NPI (01) | OR |
161133 | NORTH BEND MEDICAL CENTER GROUP MEDICAID (01) | OR |
500685167 | (05) | OR |
P01814024 | RAILROAD MEDICARE (01) | OR |
R0000WFBTV | NORTH BEND MEDICAL CENTER GROUP MEDICARE (01) | OR |