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1013958818

NPI Code Detail

MEDICARE: JEFFERY JADCZAK PT

MEDICARE: JEFFERY JADCZAK PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	J10001754	DE
2	225100000X	Physical Therapist	PT015518	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00359632	OTHER		MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30051358	OTHER	PA	KEYSTONE MERCY
2	000000215642	OTHER	PA	AMERICHOICE
4	1013958818	OTHER		BRAVO
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1483149	OTHER		HIGHMARK
7	2173675000	OTHER	PA	IBC

General Provider Information

NPI Number	:	1013958818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFERY JADCZAK PT

Provider Business Mailing Address
First Line	:	2 W 10TH ST
Second Line	:
City	:	MARCUS HOOK
State	:	PA
Zip	:	19061-4513
Country	:	US
Telephone Number	:	610-859-8850
Fax Number	:	610-859-7876

Provider Business Practice Location Address
First Line	:	8019 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-2786
Country	:	US
Telephone Number	:	215-338-8900
Fax Number	:	215-338-8923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	06/14/2010

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Directions to “ JEFFERY JADCZAK PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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