Provider Demographics
NPI:1689637126
Name:JDC PEDIATRICS
Entity Type:Organization
Organization Name:JDC PEDIATRICS
Other - Org Name:JONES, DALY, COLDREN ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCURDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-257-9900
Mailing Address - Street 1:1824 GOOD HOPE ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1233
Mailing Address - Country:US
Mailing Address - Phone:717-791-2680
Mailing Address - Fax:717-791-2686
Practice Address - Street 1:1824 GOOD HOPE ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1233
Practice Address - Country:US
Practice Address - Phone:717-791-2680
Practice Address - Fax:717-791-2686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02412000OtherCAIC GROUP NUMBER
PA1496819OtherBS GROUP NUMBER
PA0006455330003Medicaid