Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider
is Licensed or Credentialed. For more information please refer to
NPI: What You Need to Know
DR. JOCELYN RAE IDEMA D.O
Gender: FEMALE
NPI: 1700080421
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Last Updated: | 2021-10-19 | ||
| Certification Date: | 2021-10-19 |
Details
| Name | Value | ||||||||||||||||
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| NPI | 1700080421 | ||||||||||||||||
| Enumeration Date | 2007-06-14 | ||||||||||||||||
| NPI Type | 1 - Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address |
480 JOHNSON RD STE 320
WASHINGTON, PA 15301-8936 United States Phone: 412-206-6770 | Fax: 724-941-5027 View Map 
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| Primary Practice Address |
480 JOHNSON RD STE 320
WASHINGTON, PA 15301-8936 United States Phone: 412-206-6770 | Fax: 724-941-5027 View Map
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