Gorodetsky, Jeffrey S
Gorodetsky, Jeffrey S is an sole proprietor health care provider with primary practice located at 165 Mill St , Leominster MA 01453-3289. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gorodetsky, Jeffrey S can be contacted via phone (978) 466-3212.Contact Information
Primary practice address
165 Mill St
Leominster MA 01453-3289
Phone: (978) 466-3212
Fax: (978) 534-3581
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Legal Medicine | 173000000X | ME0053894 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 262412 | Massachusetts |
Profile Details
| NPI number | 1780613935 |
|---|---|
| LBN Legal business name | Gorodetsky, Jeffrey S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 1st, 2006 |
| Last updated | Oct 19th, 2015 - 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 | 1780613935 | NPPES |
| Florida | Other | 07463 | BLUE CROSS PROVIDER NUMBE |
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