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NPI Code Detail

MEDICARE: JACOB HASCHAK MMS, PA-C

MEDICARE: JACOB HASCHAK MMS, PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1972491116
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB HASCHAK MMS, PA-C
Provider Business Mailing Address
First Line : 8819 COMMONS BLVD
Second Line :
City : TWINSBURG
State : OH
Zip : 44087-4101
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8819 COMMONS BLVD
Second Line :
City : TWINSBURG
State : OH
Zip : 44087-4101
Country : US
Telephone Number : 330-410-9086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2025
Last Update Date : 06/26/2025

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