Organization
JEDWARD PCKERING,FACC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK PICKERING M.D. (OWNER)
(610) 642-0100
Entity
Organization
Contact information
Practice address
100 E LANCASTER AVE, SUITE 316 LANKENAU MED BLDG, WYNNEWOOD, PA 19096-3450
(610) 642-0100
(610) 642-0919
Mailing address
100 E LANCASTER AVE, 316 LANKENAU MED BLDG, WYNNEWOOD, PA 19096-3450
(610) 642-0100
(610) 642-0919
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
007173E
PA
Other
Enumeration date
12/27/2006
Last updated
06/18/2008
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