Healthcare Provider Details

I. General information

NPI: 1730106501
Provider Name (Legal Business Name): AIMEE ELIZABETH NEWELL PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 PULASKI HWY
BEAR DE
19701-1453
US

IV. Provider business mailing address

1522 SYCAMORE ST
WILMINGTON DE
19805-4235
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-1550
  • Fax: 302-834-1549
Mailing address:
  • Phone: 302-652-8347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: