Provider Demographics
NPI:1225106396
Name:SZILAGYI, JEFFREY THOMAS (CA LAC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:THOMAS
Last Name:SZILAGYI
Suffix:
Gender:M
Credentials:CA LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 GREENFIELD AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-2449
Mailing Address - Country:US
Mailing Address - Phone:415-454-5840
Mailing Address - Fax:415-454-5820
Practice Address - Street 1:130 GREENFIELD AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2449
Practice Address - Country:US
Practice Address - Phone:415-454-5840
Practice Address - Fax:415-454-5820
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8002171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist