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General NPI Number Information
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NPI Number | 1700758422
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Entity Type | Individual
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Provider Name | JORDYN MCDONOUGH PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 231 NORTHERN BLVD STE 1
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9189
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Country | US
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Telephone | 570-344-9997
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Fax |
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Provider Business Mailing Address
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Address Line | 63 PATRICIA CIR
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City | SPRING BROOK TOWNSHIP
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State | PA
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Zip | 18444-6363
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Country | US
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Telephone |
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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 | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | MA066975
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License Number State | PA
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