1316831829 NPI number — JOELL DAWN MCDUFFY

Table of content: JOELL DAWN MCDUFFY (NPI 1316831829)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316831829 NPI number — JOELL DAWN MCDUFFY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCDUFFY
Provider First Name:
JOELL
Provider Middle Name:
DAWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316831829
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
94 HILLSIDE DR APT A3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19464-5054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-524-2542
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
368 W UWCHLAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNINGTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19335-3319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-269-2661
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)