Individual provider · Type 1 NPI

Jerome D. Derdel, MD

Therapeutic Radiology Physician · State College, PA

NPI number 1104812601 Active

Practice location

1800 E Park Ave
State College, PA 16803-6709

Call (814) 234-6726 Map

Fax (814) 234-1553

Mailing address

100 N Academy Ave
Danville, PA 17822-4903

Specialties and licenses

TaxonomyCodeLicense
Radiation Oncology Physician 2085R0001XMD038685L (PA)
Therapeutic Radiology Physician Primary 2085R0203XMD038685L (PA)

Therapeutic Radiology Physician: Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.

115 other providers at this address

About NPI 1104812601

Jerome D. Derdel, MD's National Provider Identifier is 1104812601, issued on Sep 21, 2005. The primary taxonomy on file is Therapeutic Radiology Physician (2085R0203X), and the practice location is in State College, PA. The record was last updated on Jun 21, 2023.