Provider Demographics
NPI:1134220015
Name:SCHLAKMAN, JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:SCHLAKMAN
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 1:52 YONATAN HACHASMONAI
Mailing Address - Street 2:
Mailing Address - City:EFRAT
Mailing Address - State:ISRAEL
Mailing Address - Zip Code:90435
Mailing Address - Country:IL
Mailing Address - Phone:866-260-8818
Mailing Address - Fax:888-816-3308
Practice Address - Street 1:52 YONATAN HACHASMONAI
Practice Address - Street 2:
Practice Address - City:EFRAT
Practice Address - State:ISRAEL
Practice Address - Zip Code:90435
Practice Address - Country:IL
Practice Address - Phone:866-260-8818
Practice Address - Fax:888-816-3308
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01794556Medicaid
PA036829HKNMedicare ID - Type Unspecified
PA01794556Medicaid