Provider Demographics
NPI:1336305218
Name:GRADOWSKI, TOM JR
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:GRADOWSKI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19408-0047
Mailing Address - Country:US
Mailing Address - Phone:610-636-2252
Mailing Address - Fax:
Practice Address - Street 1:2103 E DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2409
Practice Address - Country:US
Practice Address - Phone:610-636-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography