Provider Demographics
NPI:1134136385
Name:CZAJKOWSKI, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:CZAJKOWSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:3131 COLLEGE HEIGHTS BLVD
Practice Address - Street 2:SUITE 2200
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4812
Practice Address - Country:US
Practice Address - Phone:610-433-8615
Practice Address - Fax:484-403-4019
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039406E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3184701OtherCAPITAL BLUE CROSS
PAP00356018OtherPALMETTO GBA MEDICARE
PA515197OtherHIGHMARK BLUE SHIELD
PA515197LH5Medicare PIN
PA515197OtherHIGHMARK BLUE SHIELD
PA515197KZJMedicare PIN