Doctor Name: | HOWARD DANA JADOFSKY |
NPI Number: | 1356581631 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 1101001285 |
Business Practice Address: | 102 Main St Stanardsville, VA - 229732970 |
Business Phone Number: | 4345315071 |
Business Fax Number: | 4349900126 |
Mailing Address: | Po Box 1315, STANARDSVILLE |
State: | VA |
Postal Code: | 229731315 |
Phone Number: | 4345315071 |
Fax Number: | 4349900126 |
NPI Enumeration Date: | 02/26/2009 |
NPI Last Update Date: | 02/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1101001285 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |