Individual
DR. DANIEL A PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 SCHUYLKILL MEDICAL PLZ, POTTSVILLE, PA 17901-3660
(570) 621-9270
(570) 621-9271
Mailing address
1450E CHESTNUT AVE 3D, VINELAND, NJ 08361-8469
(856) 692-0050
(856) 692-0081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB09405100
NJ
207Q00000X
Family Medicine Physician
Primary
OS021569
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/30/2011
Last updated
11/27/2023
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