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Individual

JEFFREY P KADLECIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2333 N TRIPHAMMER RD, SUITE 202, ITHACA, NY 14850-1082
(607) 257-7700
(607) 257-1237
Mailing address
2333 N TRIPHAMMER RD, SUITE 202, ITHACA, NY 14850-1082
(607) 257-7700
(607) 257-1237

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N005805
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02195908
NY
01
223797623
TAX ID
Enumeration date
10/04/2006
Last updated
06/18/2008
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