Individual
JEROLD MIKSZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 2 RAVDIN, PHILADELPHIA, PA 19104-4238
(215) 662-3606
(215) 349-5579
Mailing address
3400 SPRUCE ST, 2 RAVDIN, PHILADELPHIA, PA 19104-4238
(215) 662-3606
(215) 349-5579
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0101030137
VA
2084N0400X
Neurology Physician
Primary
MD021941E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6150560
—
VA
Enumeration date
10/26/2005
Last updated
08/26/2016
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