Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD438107 | PA |
NPI | 1134170053 |
---|---|
Provider Name | Ruxandra Oana Jadic |
First Address | Wyomissing, PA 19610-1799 |
Second Address | Wyomissing, PA 19610-1799 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 16/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023662990001 | (05) | PA |