Provider Demographics
NPI:1952744054
Name:PAJAK, THADDEUS MATTHEW (DO)
Entity Type:Individual
Prefix:DR
First Name:THADDEUS
Middle Name:MATTHEW
Last Name:PAJAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 JEFFERSON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-689-1822
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:300 CAMEO LN
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-238-6668
Practice Address - Fax:724-238-6080
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine