Provider Demographics
NPI:1023264843
Name:ORLAK, JASON BRIAN (HEARING HEALTH CARE)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:BRIAN
Last Name:ORLAK
Suffix:
Gender:M
Credentials:HEARING HEALTH CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 KIMBERLY LN
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17316-8314
Mailing Address - Country:US
Mailing Address - Phone:717-848-2288
Mailing Address - Fax:
Practice Address - Street 1:193 KIMBERLY LN
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-8314
Practice Address - Country:US
Practice Address - Phone:717-848-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03273237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist