Derdel, Jerome D.

Derdel, Jerome D. is an individual health care provider with primary practice located at 1800 E Park Ave , State College PA 16803-6709. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Radiation Oncology, Allopathic & Osteopathic Physicians / Therapeutic Radiology. Allopathic & Osteopathic Physicians / Therapeutic Radiology is his primary health care specialty. Derdel, Jerome D. can be contacted via phone (814) 234-6726.

Contact Information

Primary practice address
1800 E Park Ave State College PA 16803-6709
Phone: (814) 234-6726
Fax: (814) 234-1553
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X MD038685L Pennsylvania
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X MD038685L Pennsylvania

Profile Details

NPI number 1104812601
LBN Legal business name Derdel, Jerome D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Jun 21st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104812601 NPPES
Other 1104812601 NPI

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