Provider Demographics
NPI:1457180457
Name:GAJKOWSKI, ADAM RONALD (DNP)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:RONALD
Last Name:GAJKOWSKI
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 RHODESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ELYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17824-9135
Mailing Address - Country:US
Mailing Address - Phone:570-336-6389
Mailing Address - Fax:
Practice Address - Street 1:110 RHODESTOWN RD
Practice Address - Street 2:
Practice Address - City:ELYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17824-9135
Practice Address - Country:US
Practice Address - Phone:570-336-6389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA599468163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine