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General NPI Number Information
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NPI Number | 1376962936
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Entity Type | Individual
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Provider Name | JORGE JARA KUDIN MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 3521 SILVERSIDE RD STE 1F
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City | WILMINGTON
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State | DE
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Zip | 19810-4900
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Country | US
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Telephone | 302-478-2613
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Fax | 302-421-9743
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Provider Business Mailing Address
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Address Line | 401 ROUTE 73 N BLDG 10, SUITE 320
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-872-7055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | C1-0012077
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C1-0012077
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License Number State | DE
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