Provider Demographics
NPI:1518949130
Name:LEKACH, JAKUB (MD)
Entity Type:Individual
Prefix:DR
First Name:JAKUB
Middle Name:
Last Name:LEKACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 E DRINKER ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2481
Mailing Address - Country:US
Mailing Address - Phone:570-343-6444
Mailing Address - Fax:570-347-2620
Practice Address - Street 1:536 E DRINKER ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2481
Practice Address - Country:US
Practice Address - Phone:570-343-6444
Practice Address - Fax:570-347-2620
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-036617-E207KA0200X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAA60324Medicare UPIN
PALE422956Medicare ID - Type Unspecified