Healthcare Provider Details

I. General information

NPI: 1841260395
Provider Name (Legal Business Name): JOANNE I DURBIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 E CHOCOLATE AVE
HERSHEY PA
17033-1324
US

IV. Provider business mailing address

760 WALTONVILLE RD
HUMMELSTOWN PA
17036-9601
US

V. Phone/Fax

Practice location:
  • Phone: 717-533-7850
  • Fax: 717-533-8294
Mailing address:
  • Phone: 717-533-7850
  • Fax: 717-533-8294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD064246L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: