Provider Demographics
NPI:1194306555
Name:FIGANIAK, JAKE LAWRENCE
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:LAWRENCE
Last Name:FIGANIAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 EDGEMONT LN
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1518
Mailing Address - Country:US
Mailing Address - Phone:215-932-6544
Mailing Address - Fax:
Practice Address - Street 1:2900 W QUEEN LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1033
Practice Address - Country:US
Practice Address - Phone:215-991-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program