Provider Demographics
NPI:1710592381
Name:PAZDZIOR, JOHN P
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:PAZDZIOR
Suffix:
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 1:7791 WINDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8797
Mailing Address - Country:US
Mailing Address - Phone:614-376-6386
Mailing Address - Fax:
Practice Address - Street 1:7791 WINDWOOD DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-8797
Practice Address - Country:US
Practice Address - Phone:614-376-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2566512Medicaid