Jacob Radlich, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

003379 Issued in NY

Practice address

1 Bills Dr
Orchard Park, NY 14127-2237

Phone

(716) 939-4469

NPI assigned

Apr 6, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1649703539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 BRIARCLIFF RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142251502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BILLS DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272237",
            "telephone_number": "716-939-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLICH",
        "first_name": "JACOB",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Quijada, MD
• Kristin Quinn, LMT
• Maureen Patricia Quinn, LSLP-CCC.
• Matthew Radel
• Jeremy Wayne Rademacker, D.C.
• Gavin C Raffloer
• Joanna Raimonde
• Amy Elizabeth Ramey, PT DPT
• Jamie Randall, LMT
• Nicholas Michael Randall

• Athletic Trainer in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.