Jackowitz, Mark A

Jackowitz, Mark A is an individual health care provider with primary practice located at 3640 Main St Suite 205, Springfield MA 01107-1145. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Jackowitz, Mark A can be contacted via phone (413) 739-7367.

Contact Information

Primary practice address
3640 Main St Suite 205 Springfield MA 01107-1145
Phone: (413) 739-7367
Fax: (413) 737-2686
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 57126 Massachusetts

Profile Details

NPI number 1508851411
LBN Legal business name Jackowitz, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2005
Last updated May 23rd, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508851411 NPPES
Massachusetts Other 0115328 AETNA GROUP NO.
Massachusetts Other J06214 AETNA GROUP NO.
Massachusetts Other 0034216003 AETNA GROUP NO.
Massachusetts Other 010057126MA01 AETNA GROUP NO.
Massachusetts Other 150664 AETNA GROUP NO.
Massachusetts Other 032587 AETNA GROUP NO.
Massachusetts Other 0804490 AETNA GROUP NO.
Massachusetts Other 13334 AETNA GROUP NO.
Massachusetts Other P1500300 AETNA GROUP NO.
Massachusetts Other 180012328 AETNA GROUP NO.

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