Provider Demographics
NPI:1194412411
Name:JAKUBEK, EMILIA CECILY (MD)
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:CECILY
Last Name:JAKUBEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 JEFFERSON AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-2447
Mailing Address - Country:US
Mailing Address - Phone:570-647-9999
Mailing Address - Fax:
Practice Address - Street 1:ONE MEDICAL CENTER BLVD.
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013
Practice Address - Country:US
Practice Address - Phone:610-447-7612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program