Individual
JONATHAN SHACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E LEHIGH AVE, MAB BLDG STE 105, PHILADELPHIA, PA 19125-1000
(215) 707-8496
(215) 707-4086
Mailing address
3425 N CARLISLE ST, 2ND FLOOR HUDSON BLDG, PHILADELPHIA, PA 19140-5108
(215) 707-4739
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD045140L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013992500004
—
PA
Enumeration date
10/12/2005
Last updated
07/08/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us