Phadke, Jayant Gopal

Phadke, Jayant Gopal is an individual health care provider with primary practice located at 123 Summer St Ste 695, Worcester MA 01608-1216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Phadke, Jayant Gopal can be contacted via phone (508) 363-5630.

Contact Information

Primary practice address
123 Summer St Ste 695 Worcester MA 01608-1216
Fax: (508) 363-5630
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 078071 Massachusetts

Profile Details

NPI number 1467436055
LBN Legal business name Phadke, Jayant Gopal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated May 14th, 2012 - about 13 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 1467436055 NPPES
Massachusetts MEDICAID 3111083

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