JONATHAN SHACK

PHILADELPHIA, PA
NPI1629066626
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: PA  MD045140L)
Enumeration Date2005-10-12
Last Update Date2007-07-08
Business Address
-- JONATHAN SHACK MD
100 E LEHIGH AVE MAB BLDG STE 105
PHILADELPHIA, PA 19125-1000
Phone number: 215-707-8496
Mailing Address
-- JONATHAN SHACK MD
3425 N CARLISLE ST 2ND FLOOR HUDSON BLDG
PHILADELPHIA, PA 19140-5108
Phone number: 215-707-4739