Provider Demographics
NPI:1093427528
Name:MATTHEW GAJKOWSKI
Entity Type:Organization
Organization Name:MATTHEW GAJKOWSKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:GAJKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-836-8661
Mailing Address - Street 1:1458 COPLEY RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-2654
Mailing Address - Country:US
Mailing Address - Phone:330-836-8661
Mailing Address - Fax:330-836-8661
Practice Address - Street 1:1458 COPLEY RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2654
Practice Address - Country:US
Practice Address - Phone:330-836-8661
Practice Address - Fax:330-836-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty