MEDICARE: ACKROYD PEDIATRICS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD 047071 L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235183658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACKROYD PEDIATRICS PC

Provider Business Mailing Address
First Line	:	831 PROVIDENCE RD
Second Line	:
City	:	SECANE
State	:	PA
Zip	:	19018-2921
Country	:	US
Telephone Number	:	610-622-7533
Fax Number	:	610-622-7693

Provider Business Practice Location Address
First Line	:	831 PROVIDENCE RD
Second Line	:
City	:	SECANE
State	:	PA
Zip	:	19018-2921
Country	:	US
Telephone Number	:	610-622-7533
Fax Number	:	610-622-7693

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID ALAN ACKROYD
Credential	:	M.D.
Telephone Number	:	610-622-7533

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/22/2020

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