Provider Demographics
NPI:1215764618
Name:LACHNISH, JORDAN (MD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:LACHNISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 MAZEH ST.
Mailing Address - Street 2:ENTRANCE B/ APT 2
Mailing Address - City:TEL AVIV
Mailing Address - State:ISRAEL
Mailing Address - Zip Code:6578917
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 DERECH SHEBA ST.
Practice Address - Street 2:SHEBA MEDICAL CENTER, ORTHOPEDIC DEPARTMENT
Practice Address - City:RAMAT GAN
Practice Address - State:ISRAEL
Practice Address - Zip Code:5266202
Practice Address - Country:IL
Practice Address - Phone:650-249-6282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ147185207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery