Provider Demographics
NPI:1922672856
Name:JADASZEWSKI, STEFAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:
Last Name:JADASZEWSKI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 MAIN ST APT 10
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-0604
Mailing Address - Country:US
Mailing Address - Phone:603-834-5313
Mailing Address - Fax:
Practice Address - Street 1:763 MAIN ST APT 10
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-0604
Practice Address - Country:US
Practice Address - Phone:603-834-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling