Healthcare Provider Details

I. General information

NPI: 1851507065
Provider Name (Legal Business Name): ALBERT JAY MAJZLIK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 WAYNE AVE
ELLWOOD CITY PA
16117-2038
US

IV. Provider business mailing address

524 WAYNE AVE
ELLWOOD CITY PA
16117-2038
US

V. Phone/Fax

Practice location:
  • Phone: 724-758-6138
  • Fax: 724-758-6299
Mailing address:
  • Phone: 724-758-6138
  • Fax: 724-758-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-1841-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: