Healthcare Provider Details

I. General information

NPI: 1235183658
Provider Name (Legal Business Name): ACKROYD PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 PROVIDENCE RD
SECANE PA
19018-2921
US

IV. Provider business mailing address

831 PROVIDENCE RD
SECANE PA
19018-2921
US

V. Phone/Fax

Practice location:
  • Phone: 610-622-7533
  • Fax: 610-622-7693
Mailing address:
  • Phone: 610-622-7533
  • Fax: 610-622-7693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 047071 L
License Number StatePA

VIII. Authorized Official

Name: DR. DAVID ALAN ACKROYD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-622-7533