Provider Demographics
NPI:1518070606
Name:NARDONE, JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:NARDONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 LANCASTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRAZER
Mailing Address - State:PA
Mailing Address - Zip Code:19355
Mailing Address - Country:US
Mailing Address - Phone:610-695-8905
Mailing Address - Fax:610-695-8906
Practice Address - Street 1:289 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FRAZER
Practice Address - State:PA
Practice Address - Zip Code:19355-1838
Practice Address - Country:US
Practice Address - Phone:484-883-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1652234OtherHIGHMARK BLUESHIELD
PAV02391Medicare UPIN
PA1652234OtherHIGHMARK BLUESHIELD