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General NPI Number Information
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NPI Number | 1336305218
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Entity Type | Individual
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Provider Name | TOM GRADOWSKI JR.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 2103 E DARBY RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-2409
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Country | US
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Telephone | 610-636-2252
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 47
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City | EAGLEVILLE
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State | PA
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Zip | 19408-0047
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Country | US
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Telephone | 610-636-2252
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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