Healthcare Provider Details

I. General information

NPI: 1720322977
Provider Name (Legal Business Name): JORDAN PEKEVSKI PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2012
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18TH MEDICAL GROUP, UNIT 5142
APO AP
96368-5142
US

IV. Provider business mailing address

18TH MEDICAL GROUP, UNIT 5268
APO AP
96368
US

V. Phone/Fax

Practice location:
  • Phone: 98-960-4817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: