Individual
MR. JARRETT PETER KACZMARSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
506 MALCOLM X BLVD, MLK RM 3101A, NEW YORK, NY 10037-1802
(212) 939-2390
Mailing address
520 W 48TH ST APT 7N, NEW YORK, NY 10036-1147
(917) 687-2381
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0084761
NY
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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