Individual
JACOB GILDEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 S 2ND ST, STE 301, HARRISBURG, PA 17101-2545
(717) 782-3340
(717) 782-5352
Mailing address
PO BOX 536003, PITTSBURGH, PA 15253-5902
(800) 475-6236
(843) 497-9566
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
MD-441990
PA
207ZC0500X
Cytopathology Physician
MD-441990
PA
207ZD0900X
Dermatopathology (Pathology) Physician
MD-441990
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD-441990
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025892300001
—
PA
01
—
P00939323
RAILROAD MEDICARE PTAN
PA
Enumeration date
01/26/2007
Last updated
07/17/2019
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