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Individual
MR. JACEK GOLIS
Active
Individual
MR. JACEK GOLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
025552
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013701
ORTHONET AETNA HMO
—
01
—
0222701
ORTHONET CIGNA HMO
—
01
—
0764866
CIGNA PPO
—
01
—
1177828
AETNA HMO
—
01
—
7022766
AETNA PPO
—
01
—
Q34B8
EMPIRE BCBS
—
Enumeration date
01/17/2006
Last updated
07/08/2007
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