Provider Demographics
NPI:1720833882
Name:JEFFREY L. GOLOMBISKY
Entity Type:Organization
Organization Name:JEFFREY L. GOLOMBISKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-723-8135
Mailing Address - Street 1:1336 E M 21
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9039
Mailing Address - Country:US
Mailing Address - Phone:989-723-8135
Mailing Address - Fax:989-723-8649
Practice Address - Street 1:1336 E M 21
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9039
Practice Address - Country:US
Practice Address - Phone:989-723-8135
Practice Address - Fax:989-723-8649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental