Provider Demographics
NPI:1780213132
Name:WARDLAW, JOCELYN ROSE (DO)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:ROSE
Last Name:WARDLAW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-3670
Mailing Address - Fax:202-476-4741
Practice Address - Street 1:200 MARTER AVE STE 100
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3147
Practice Address - Country:US
Practice Address - Phone:856-235-2147
Practice Address - Fax:856-235-6905
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2023-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB11901600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics