Individual
ELZBIETA EWA JACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5649 WYNNEWOOD DR STE 203, LAURYS STATION, PA 18059-1124
(610) 261-1123
(610) 262-1739
Mailing address
2100 MACK BLVD, ALLENTOWN, PA 18103-5622
(484) 884-0617
(484) 884-0628
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD471194
PA
390200000X
Student in an Organized Health Care Education/Training Program
271782
MA
Other
Enumeration date
05/03/2017
Last updated
09/01/2020
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