Provider Demographics
NPI:1043703135
Name:JAKIMOVSKI, IVAN (MD, MPH, DABFM)
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:JAKIMOVSKI
Suffix:
Gender:M
Credentials:MD, MPH, DABFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MINNISINK ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512
Mailing Address - Country:US
Mailing Address - Phone:862-657-3066
Mailing Address - Fax:
Practice Address - Street 1:225 MINNISINK ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:862-657-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11029700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine