Individual
JAKUB HALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 N 15TH ST, PHILADELPHIA, PA 19102-1198
(215) 762-7916
Mailing address
245 N 15TH ST, PHILADELPHIA, PA 19102-1101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT219211
PA
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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