Individual
MARK W JANKOWSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01107-1619
(413) 794-2398
(413) 794-1273
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11922196-1204
UT
208000000X
Pediatrics Physician
Primary
246441
MA
208M00000X
Hospitalist Physician
246441
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002340301
MEDICARE
MA
05
—
110089862A
—
MA
Enumeration date
05/21/2007
Last updated
09/09/2020
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