Provider Demographics
NPI:1619184454
Name:HARER, JENDY YON (DO)
Entity Type:Individual
Prefix:
First Name:JENDY
Middle Name:YON
Last Name:HARER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENDY
Other - Middle Name:
Other - Last Name:YON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:1205 RIVER AVE FL 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3724
Practice Address - Country:US
Practice Address - Phone:570-326-4118
Practice Address - Fax:570-326-5533
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA165908F6KOtherMEDICARE
PA1023708900003Medicaid
PA165908Medicare PIN