IndividualActive
Jerome Derdel, MD
NPI 1104812601 · Therapeutic Radiology Physician · State College, PA
Provider details
- NPI number
- 1104812601
- Entity type
- Individual
- Primary specialty
- Therapeutic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MD038685L (PA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1800 E Park Ave
State College, PA 16803-6709
Phone: (814) 234-6726
Fax: (814) 234-1553
Approximate (ZIP-level) locationGet directions
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Registry dates
- Enumerated
- 2005-09-21
- Last updated
- 2023-06-21
- Certified
- 2023-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.